EmailMe Form - New England Wholesale Florist Customer Application

Company Legal Name:

Applicant Name:

Company Owner's Name

(Leave blank if same as applicant)

Email

Phone

### - ### - ####

Web Site

Address:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Years In Business (Approximate)

Select The Option Which Best Describes Your Company:

A Physical Walk-In Retail Shop (With Tax ID)

A Designer Without A Walk-In Store (With Tax ID)

Not a Registered Business (No Tax ID)

Upload Your CT Sales Tax Resale Certificate

Sales Tax Exemption:

I certify that all purchases are for resale and not personal use

Note: Not-for-resale purchases and clients without resale tax IDs will be charged CT sales tax.

Terms of Sale Check: *

I understand that this is a Customer Application Form, and not a Credit Application form. New England Wholesale does not offer Credit Terms, and all accounts are strictly COD.

By signing the box below, I certify that the information provided on this form is accurate & complete *

Clear