Registration Form (* = required) *Last Name: *First Name: *Middle Initial: *Address 1: Address2: *City: *State: Select from list... Alabama Alaska Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Outside US *Zip Code: *Primary Contact Phone #: ( ) - Work Phone#: ( ) - Cell Phone #: ( ) - *E-mail Address: *Verify E-mail Address: *Number of Barcodes Needed: (Max. 70 per consignor) (Max. 100 per worker) (worker shifts will be confirmed at barcode pickup.) PLEASE ENTER THE REGISTRATION NUMBER ON THE MAILING LABEL OF YOUR FLYER IN THE SPACE PROVIDED BELOW. THIS WILL ASSIST US IN UPDATING YOUR INFORMATION. !!!Each Consignor Must Enter Their Own Registration Number!!! Registration #: Return to Kids' Kloset