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Thank you for your interest in learning more about business opportunities with The Rosie Network and ePS.  We will review your form and be in contact with you within 3 business days. Next steps will include an invitation to  upcoming webinars that best match your business profile. For questions, please contact ePS Solutions Consultants at sales@eprosvcs.com or 855-690-3774

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* 1. Business Name (Official/Legal): Ex. Veteran Auto Supply

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* 2. Primary Contact (Main Contact):

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* 3. Additional Contact:

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* 4. Business Website URL: Ex. - www.ndvsb.com 

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* 5. Products & Services: (Select any that apply)

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* 6. Do you currently resell products from a national wholesaler? If yes, please list wholesaler name(s).

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* 7. Are you currently a registered member of Rosie's List?

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* 8. What National Certifications do you have?

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* 9. Please list any State or Local Certifications

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* 10. Number of Employees

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* 11. Estimated Annual Revenue

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* 12. Do you have a credit line established with a bank? If so, how much?

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* 13. Year Business Was Established

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* 14. Complete Address:

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