PVS Registration Form
This is a one-time form.  Completing this form gives us everything we need to service you.  We will refer to it every time we have an order from you.  If you have any special instructions not noted on this form, please place a note inside your pick up bag or pin it to the specific article.  
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Your First Name
Your Last Name
Your Birthday
Spouse First Name
Spouse Last Name
Spouse Birthday
Home Street Address
Home City
Home State
Home Zip
Mobile Phone
Home Phone
Work Phone
Email Address
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