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Dealer Registration Form

To create an account with us, please fill out the form on the following page. Once submitted CTC will review your information and notify you via email with your temporary log in ID. All requests must be approved for territory. All fields marked with an * are required.

*Account Name:
Company Contacts
*Buyer:
*Phone:	Fax:
*E-mail:
*Accounts Payable:
*Phone:	Fax:
*E-mail:
Company Address
*Billing Address 1:
*Address 2
*City:	*Zip:
*Country:	*State:
*Shipping Address 1:
*Address 2
*City:	*Zip:
*Country:	*State:
Phone:	Fax:
*E-mail:
Website:
Invoice Preference
*Receive Invoices By:	E-mail Fax Mail
*Type of Business
Furniture Store/Gallery Program Gift/Specialty Store Home Staging Commercial Contract Design Firm Garden Center/Nursery/Florist Interior Design Firm Architectural Firm ecommerce ASID Affiliate: Yes No	Home Accent Store Department Store Event Planner Hotel/B&B/Hospitatilty Model Home Specifier Custom Workroom Interior Designer/Decorator Other:
Does your business have a storefront: Yes No
Number of Locations:

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