Vending Application

Please send payment to:
Grace Christian Counseling Center 
1414 Cherry St.
Vicksburg, MS 39180

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* 1. Name:

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* 2. Business:

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* 3. Mailing Address:

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* 4. City:

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* 5. State:

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* 6. Zip Code:

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* 7. Email:

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* 8. Phone:

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* 9. List Items For Sale:

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