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Vending Locator Agreemen
Please complete this application, copy, paste and email it to bluemooseloc@yahoo.com

Name_________________________________

Business name______________________________________

Address___________________________________________

City____________________________St_____________zip_________

Phone__________________________email______________________

Type of equipment to be located________________________________

__________________________________________________________

Areas by zip code____________________________________________

__________________________________________________________


Have you read and agreed to our terms as listed on this website.  Are you

sending your deposit via paypal or money gram.


_______________________________________  
signature (typed signature is accepted)

Date___________________________________
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