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Wholesale Application Form

Thank you for your interest in Omax Decor. Please fill out the form below in order to apply for a wholesale account. We will reply with your application status via email within 2-3 business days.


Business Information

Company Name *

Owner's/Buyer's Name *

DBA

Tax ID or State Resale Cert *

Copy of Tax ID or Resale Cert

Phone *

Fax

Email *

Website


Business Type

Online StoreRetail StoreDesigner/ArchitectOther Other

Notes

Billing Information

Address Line 1 *

Address Line 2

City *

State *

Zip *


Shipping Information

Address Line 1 *

Address Line 2

City *

State *

Zip *


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