Primitive Auction Registration
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Account Information
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*First Name
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*Last Name
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*Email Address
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*Password
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Passwords must be at least eight characters long. |
*Confirm Password
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*Phone Number
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Billing Address
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*Street Address
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*City
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*State, or
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Province |
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*Country
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*Zip/Postal Code
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Shipping Address
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Is your shipping address the same as your billing address?
Yes
No
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*Street Address
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*City
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*State, or
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Province |
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*Country
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*Zip/Postal Code
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Credit Card
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*Card Type
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*Card Number
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*Security Code
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*Expiration Date
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Month
Year
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RSVP me for the live auction event at Primitive on Friday, February 25th at 6pm.
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*I have read and agreed to the
conditions of sale to complete
this registration.
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