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E LAST NAME NICKNAME FOR BADGE TITLE COMPANY NAME ADDRESS CITY COUNTRY PHONE NUMBER Is this your permanent contact information? FAX NUMBER YES NO STATE ZIP/POSTAL CODE EMAIL ADDRESS If yes, this information will be used for all NACS mailings & events. Check here if you require special assistance. A NACS staff member will contact you to discuss your needs. REGISTRATION Registration for the NACS State of the Industry Summit is FREE for up to three individuals per retail member com.

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