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NORTHEAST CAMPUS STORES ASSOCIATION

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* Mandatory fields
*First name
*Last name
Pronouns
*Title
*School/Company Name
For reporting purposes, please enter the same name for each member of the bundle. This information must be consistent across all entries.
Store Name (If Applicable)
For reporting purposes, please enter the same name for each member of the bundle. This information must be consistent across all entries.
*Email
Phone
Please enter phone numbers in this format:
(123) 456-7890
Photo
For Vendor Representatives: What geographic territory do you represent?
Please describe the geographic area you represent (e.g., entire states, specific counties, regions, or individual campuses). This information will be displayed in the membership directory to help stores locate the appropriate representative.
 
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