Existing Customer-Online Account Request

Please fill out the required information to get started ordering through the Couture Tee web-site!
Company Name*
Contact Name*

First NameLast Name
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Fax Number

Area Code Fax Number
E-mail*
This is the email address you will use to login to your account.
Password*

Please choose something secure and easy to remember.0/12
Sales Tax ID Number*
Include Dashes
Copy Of Sales Tax Certificate*

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Comments or Questions
Thank you for your continued partnership with Couture Tee Company! We will email you as soon as your online account is active.
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