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Food 4 BSV - Customer Application Form
Your name
Your email address
Name of Merchant (Owner and/or Business Name)
Type the name of the business owner and/or the name of the business.
Extra Comment
This is optional but you can introduce yourself further, or why you want to do participate.
CAPTCHA
Math question
4 + 0 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.