Midwest Diamond Distributors - Request an Account

To request a Midwest Diamond Distributors account, please complete the form below.

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Pricing Information

Customer Markup

Customer URL

http://www.midwestdiamond.net/

Billing Information

All information is required, except for Suite/Apartment.

First Name:

Last Name:

Company:

Address:

Suite/Apartment:

City:

State:

Zip Code:

Phone Number:

Shipping Information

Same as Billing Information

First Name:

Last Name:

Company:

Address:

Suite/Apartment:

City:

State:

Zip Code:

Phone Number:

Phone: (513) 769-7222
Toll Free: (800) 900-6139
Fax: (513) 769-7922

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