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Type of Request:*BusinessIndividual

Language:* English Francais

First Name:*

Last Name:*

Title:

Company Name:*

Address (No PO Box):*

Address Line 2:

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Province:*Please select...AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuébecSaskatchewanYukon

Postal Code:*ex. X0X 0X0

Country:Canada

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Company Size:*Please select... 1 2-7 8-19 20-49 50-100 100+

Business Type:*Please select...AccountingAdvertising MarketingAgricultural ServicesArchitectAuto/Repair/LeaseBanking/FinanceBusiness ServicesCommunicationsConstructionEducationEngineerFarmingFish/Hunt/TrapForestryGovernmentHotels/MotelsIndependent ProfessionalInsuranceLegalManagement ServicesManufacturingMedicalMiningMotion PicturesNon ProfitPersonal ServicesPrinting PublishingReal EstateRecreationRestaurant/BarRetailerSocial ServicesTransportUnknownUtilitiesWholesalerOther

Where have you shopped?Please select...Staples StoreCatalogue/Delivery ServiceBothNever Shopped Staples Before

How did you first hear about Staples Business Depot?Please select...Existing CustomerFriend/ColleagueInternetMagazineMail In Card or Other CardNewspapers/Circulars/FlyersRadio/TVSales RepSaw/Visited a StoreStaples MailingOther/UnknownYellow Pages

Would you like to be contacted by a Staples sales representative?NoYes