Applicant Name *

First Name

Last Name

Business Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

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Buyers Classification

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Architect

Interior Designer

Interior Decorator

Type of Business

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Residential

Contract/Commercial

Other

Professional Affiliations

ASID

IIDA

NCIDQ

Consent

By submitting this form, you're consenting to our business policy. The signer of this contract is under the complete understanding that they are solely responsible for returning all materials and merchandise in the manner in which they are taken out. In additions, all special order items require a 50% deposit at the time the order is placed with balance due upon receipt.

I agree to Designers Gallery policy.