New Client Account Registration

Company Name

Billing/Company Address

Street Address

Address Line2

City

State / Province / Region

Postal / Zip Code

Country

Primary Contact

E-Mail Address

Phone

Account Type

Designer/Decorator

Contractor/Installer

End User

Purchasing Agent

Student

Type of Business (please select your primary form of business)

Hospitality Residential Corporate Other

Do you frequent a local design center for product selections or do you rely on local sales representative visits?

I shop at local design center

I rely on sales representative visits

Both

Neither

Do you currently have a sample library that supports binder or memo storage?

Yes

No

Website

Attach any Resale Certificate(s) you may have and/or proof of business (business card, etc.)

Comments/Questions for Innovations