Simple Pleasures Retailer Request Form

Dear Retailer:

We welcome your interest in Simple Pleasures: Healthful Everyday Kosher Recipes for Body & Soul.
Please complete the form below, and a JCN representative will contact you shortly.

Name of Store: *		*Required
Address: *
City: *	State/Province: *	Zip: *
Contact Name: *		Title: *
Phone: *	Best time to call:
How can we help you?

Thank you for your request.