Information Form

Please provide the following information.
Required Fields are designated with an *.

My business is the following: Outlet Mall Outlet Store Factory Store

Business Name *


Business Hours


Business Address*


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Zip Code


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Web Site URL:


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Please provide the following Owner/Manager Contact Information. This information is for file purposes only and is kept Confidential. Required Fields are designated with an *. This information must be provided to be included in This is Our Texas Shopping Guide.

First Name *


Last Name *


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Zip Code *


E-mail Address*


Phone Number



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