Shell Buying Club - New Member

Please enter the following information. Once you have completed the form, you will have access to the member side of our website where you can learn more about who we are, what we do, and how we can help you increase your profitability.

First Name:
Last Name:
Location Name:
Location Address:
City:
State:
Zip Code:
Email:
Confirm E-mail:
Password:
Confirm Password:
Buying Group:

Location Size:	1000 square feet or more less than 1000 square feet
# of Locations:
Retailer Name:
Contact Name:
Phone Number:
Fax Number:
Primary Grocery Distributor:
Primary Grocery Distributor Acct#:
Royal Buying Group Terms & Conditions I agree to the Royal Buying Group Terms & Conditions.

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