B2B Wholesale Discount registration form

Approval is subject to the nature and viability of your business to market our products, as well as
verification of existing exclusivity agreements that we may have within your area.

We will process your application promptly and reply to you with either result.

If approved, you will receive an email with your B2B Wholesale Discount Code
that will enable you to purchase from our web site, with a B2B Wholesale discount.

Company/Store Name   Required
Street Address   Required
City   Required
State/Province   Required
Zip/Postal Code   Required
Business Phone  
The telephone MUST be registered to the Business!
(10 Digits-No spaces or dashes) Required
FAX   (10 Digits-No spaces or dashes)  
E-mail   Required
Web Site  Required
Buyer/Contact Name   Required

Due to the unique nature of our product, we are quite selective with stores featuring our exclusive collections.
Please tell us about your business that could help us to better evaluate your B2B Wholesale Business Application.

Tell us about your Business
Please, give us additional information about your business that could help us to better evaluate your application.

Have you previously purchased from Artistica?      Yes          No

How old is the business you are applying for?
Less than 1 Year    Over 1 Yr. Less than 5 Yrs.    Over 5 Yrs. less than 10 Yrs.    Over 10 Years

What kind of Business or Store do you have?
One only option allowed. Please select the one that better describe your business.

Accent Furniture Antiques Floral Dec. Accessories
Collectibles Garden Access. Lighting Furniture
Wall Decor Gift/Tabletop Mail Order Cat. Other