Thank you for submitting your information to Mariposa. We will verify
this information and contact you with a customer number. This number
will enable you to view wholesale pricing and to begin ordering
Mariposa products right away.

If you are a current wholesale customer, please enter your order in the
space below or you may fax your order to 760-632-0119.

Name:*
Company:
Address:
Phone:
E-mail:*
Are you a current Customer?* Yes No
Resale number*		State*	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
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