Retailer Registration for The January 2012 Michigan Shoe Market

Welcome Retailers!

We are pleased that you will be attending our January 2012 Market!

Thank you for taking a moment to pre-register so we can have your nametag(s) waiting for you at the Michigan Shoe Market Registration Desk!

Please feel free to contact us if you need any additional information! - Click Here to Contact Us

General Information

Please fill out these fields in ALL CAPS. Thank You!

Store Name: *

Your Name: *

Your Title: *

(Please select one. 'O' for owner, 'B' for buyer,'E' for employee, or 'Other')

1. Additional Person or Buyer:

2. Additional Person or Buyer:

3.. Additional Person or Buyer:

Address: *

City: *

State: *

Zip Code: *

Phone Number: *

Please enter your phone number in this format: xxx-xxx-xxxx

Fax Number:

Please enter your fax number in this format: xxx-xxx-xxxx

E-Mail Address:

Is This A Private Email Address?:

Yes

If you check "Yes" we will only use your e-mail address to advise you of upcoming shoe shows.

Anything Else You Would Like Us To Know?: