New Customer Registration Form

Wholesale Account Application

Upholstery+ Businesses - Apply for Wholesale Customer Account
Customer Details
Business Name*
Owner or Primary Contact*

First NameLast Name
Phone Number*
Extension
E-mail*
example@example.com
Company Street Address*

Street Address

Street Address Line 2

CityState

Zip Code
Same as street address
Company Mailing Address*

Mailing Address

Mailing Address Line 2

CityState

Zip Code
Accounting Contact Information

Same as primary contact
Accounting Contact Name*

First NameLast Name
Accounting Email*
example@example.com
Accounting Phone*
Please enter a valid phone number.
Accounting Extension
Business EIN*
Description of your business - the customers and industry you serve:*
Number of Employees
How did you hear about us?*
Please Specify*
Upload your valid business license*

Cancelof
Eligible for tax-exempt transactions

Yes
Upload your reseller certificate*

Cancelof
Should be Empty:

Wholesale Account Application