Nebraska Retail Registration Store Name * Store Address Address Line 1 * Address Line 2 City * State * Zip Code * Mailing Address (if different) Address Line 1 Address Line 2 City State Zip Code Phone * Email Address * Name 1 * First Last Title 1 * Name 2 First Last Title 2 Name 3 First Last Title 3 Name 4 First Last Title 4 Product Categories: A = Accessories/Jewelry / B = Bridal / C = Contemporary / E=Denim D=Dresses/Suits / F= Footwear/ H= Hosiery / G =Gift-Home Décor J=Juniors / K=Kids / L=Lingerie / M= Menswear O=Outerwear / Coats / P= Maternity / S=Sportswear – Resort W =Western Wear / X= Retailer Supplies / Y =Swimwear List Category Interest(s) Example: A, K, O Price Code: B =Better P = Popular/Low M=Moderate List Price Point Carried Size Codes: J = Junior / M = Misses P= Petites / X= Plus Sizes List Sizes Carried Comments, Questions?