Apply for an Account

Business Details

Company Name*

Phone*

Fax

Email*

Website

Mailing Address*

Street Address City State Zip Code Country

Shipping Address (if different)

Street Address City State Zip Code Country

Mailers

Would you like to receive complimentary product binders in the mail?

Yes
No

Owner/Officer*

Title*

Owner/Officer

Title

Owner's Social Security Number

(Please enter if not a corporation.)

Date Business Started*

Business Structure*

Sole Proprietorship
Partnership
Corporation

Accounts Payable Contact*

Accounts Payable Email*

Federal ID #

(Enter numbers only, without dashes.)

Sales Tax License

Max. file size: 6 MB.

Attach PDF here or fax/mail a copy. If your PDF is over 6 MB, please compress it first.

City of Boulder Sales Tax #

(Enter numbers only, without dashes.)

City of Boulder Sales Tax License

Max. file size: 6 MB.

Attach PDF here or fax/mail a copy. If your PDF is over 6 MB, please compress it first.

Resale Tax #*

(Enter numbers only, without dashes.)

I certify that all my purchases from Ona Drapery are for resale purposes and that I am responsible for all sales tax applicable in my state.

Terms Requested*

Invoices will be emailed. We reserve the right to place any account on Prepaid which is repeatedly past due.

Net 30
Credit card (VISA or MC)
Proforma check

Credit Card Information

To expedite your approval and for credit card accounts, provide company credit card (no third party credit cards). We accept Visa and MasterCard.

Card Number

Expiration

CVV

What is this?

Name on Card

Billing Address (if different from above)

Street Address City State Zip Code Country

Trade References

For Net 30 accounts. Use the fields below, or attach your own reference sheet.

Reference Sheet

Max. file size: 6 MB.

Attach PDF here or fax/mail a copy separately. If your PDF is over 6 MB, please compress it first.

Reference 1

Name

Account #

Phone

Fax

Address

Street Address City State Zip Code Country

Reference 2

Name

Account #

Phone

Fax

Address

Street Address City State Zip Code Country

Reference 3

Name

Account #

Phone

Fax

Address

Street Address City State Zip Code Country

Confirmation

I hereby certify that the above information is correct and that I understand and will abide by the terms of sale.

Signed*

Title*

Email

This field is for validation purposes and should be left unchanged.

Ona Drapery Hardware

Business Details

Credit Card Information

Trade References

Reference 1

Reference 2

Reference 3

Confirmation

Ona Drapery Hardware

My Design