Retailer Portal Registration Form
Please fill out the following information in order to process your Retailer Portal account registration.

**FOR THE USE OF STATE ALCOHOLIC BEVERAGE RETAIL LICENSE HOLDERS ONLY**

Please Note: If you would like to report more than 5 account locations, please contact your customer service representative.
Do you have an existing account with Craft Beer Guild of CT? *
First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Phone number *
Your answer
Sales Representative's Name
(If you already have an account with Craft Beer Guild of CT. Leave blank if unknown.)
Your answer
Does your account operate on a seasonal basis? *
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