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Client Account – Ga Concentrates Store

Client Account Information

General Information
Email
Last
First
Address1
Address2
City
State
ZipCode
Work Phone
Cell Phone
Password
Confirm Password
Only use to change password.Hide Password

Shipping Information
Name
Address1
Address2
City
State
ZipCode
Ship to Phone
(Same as General Information)

Billing Information
Bill to Name
Address1
Address2
City
State
ZipCode
Bill to Phone
(Same as General Information)

Admin User Fields
Is Administrator
Rep Application
Is Rep
IsWholesaler
IsPayLess
Is Make Money
Discount
Parent ID
Active