SHADOW FLY NEW CUSTOMER INFORMATION FORM

1. Full Name of Business *
2. Postal Address: *
3. Country: *
4. Phone Number: *
5. E-Mail Address: *
6. Shipping Address (If different from above)

1. Name: *
2. Contact E-Mail: *
3. Contact Tel Number: *

1. Retail Shop
2. Fishing Lodge
3. Internet/E Commerce Shop
4. Wholesale Distributor
5. Local / Home Distributor

1. Atlantic Salmon Flies
2. Canadian Salmon Flies
3. Steelhead Flies
4. Sea-Trout Flies
5. Trout Flies
6. Bespoke patterns
7. Fly-Tying Products

Please list 3 references and contact details of fly-fishing related suppliers that you have made purchases from:

1. 1.
2. 2.
3. 3.