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| ACCOUNT APPLICATION |
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Port 68 is available to the trade only.
To qualify for an account, you must be a retailer or design professional in the home furnishings, decorative accessories, hospitality, or gift industries.
On approval, you will receive account information and login information for our website.
To open an account via the web, simply fill out the Account Application (Step 1) and your Sales & Use Tax Information (Step 2) in the online forms below.
To open an account via fax, click the links below to download the required forms. Please fill out these forms completely and fax (using the fax cover sheet) to 866.960.5281:
In order to ensure that we receive all the forms necessary to process your application, please choose to either open the account online or open the account via fax. Please do not submit one portion and fax another.
On approval, your account information and login information will be forwarded to your email address.
Step 1 - Account Application (* required fields)
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| Company Name: | * |
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| Company Contacts: |
| Buyer: | * |
| Business Phone (buyer): |
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Fax: |
| Email: |
* |
| Accounts Payable: |
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| Business Phone (AP): |
Fax:
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| Email: |
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| Company Address: |
| Billing Address: |
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| City: |
*
State:
Zip:*
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| Country: |
*
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| Shipping Address: |
* |
| City: |
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State:
Zip:*
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| Country: |
*
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| Business Phone (Company): | * Fax: |
| Email (This is your website username): | * |
| Password: (Limit 10 characters) | * |
| Website: | |
| Notify me about special events at this store. |
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| Invoice Preferences: |
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Type of Business:
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| Does your business have a storefront? Yes No |
| Number of locations: |
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Additional Store Locations:
If placing orders that will be shipped to multiple store locations, please include store name, address, and phone number in the box below. |
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