Glass Tiles Etc. welcomes trade professionals and offers discounts to the trade.
If you are an architect, interior designer, contractor, or other trade professional,
we invite you to apply for a trade account by filling out the application below.
|
General Company Information
|
|
Company Name* |
|
|
Contact Name* |
|
|
Job Title* |
If Other, please specify:
|
|
Email* |
|
|
Web Site URL |
|
|
Tax ID* |
|
|
How Long in Business* |
|
|
Shipper Name |
|
|
Shipper Account No. |
|
|
Company Structure* |
If Other, please specify:
|
|
Business Type* |
If Other, please specify:
|
Authorized Persons
for Order Placing* |
|
Delivery Address
You will have the option to ship specific orders to alternate locations.
|
|
Delivery Address* |
|
|
Address* |
|
|
City* |
|
|
State* |
|
|
Zip* |
|
|
Phone* |
(eg. xxx-xxx-xxxx)
|
|
FAX |
(eg. xxx-xxx-xxxx)
|
|
Billing Address (if different)
|
|
Address |
|
|
City |
|
|
State |
|
|
Zip |
|
|
Phone |
(eg. xxx-xxx-xxxx)
|
|
FAX |
(eg. xxx-xxx-xxxx)
|
Trade Reference #1
Three industry-related Trade References MUST be included.
|
|
Company Name #1* |
|
|
Contact Name |
|
|
Address* |
|
|
City* |
|
|
State* |
|
|
Zip* |
|
|
Phone* |
(eg. xxx-xxx-xxxx)
|
|
FAX |
(eg. xxx-xxx-xxxx)
|
|
Email |
|
Trade Reference #2
Three industry-related Trade References MUST be included.
|
|
Company Name #2* |
|
|
Contact Name |
|
|
Address* |
|
|
City* |
|
|
State* |
|
|
Zip* |
|
|
Phone* |
(eg. xxx-xxx-xxxx)
|
| FAX |
(eg. xxx-xxx-xxxx)
|
|
Email |
|
Trade Reference #3
Three industry-related Trade References MUST be included.
|
|
Company Name #3* |
|
|
Contact Name |
|
|
Address* |
|
|
City* |
|
|
State* |
|
|
Zip* |
|
|
Phone* |
(eg. xxx-xxx-xxxx)
|
| FAX |
(eg. xxx-xxx-xxxx)
|
|
Email |
|
|
|
|
|
|