Company Members

Name *

Title *

Name

Title

Name

Title

Name

Title

CREDENTIALED DESIGN PROFESSIONAL DOCUMENTATION MUST BE CURRENT AND ACTIVE

Attach files below: *

Please attach current and active documentation for one of the following: - Proof of current ASID Membership - Resale or Sales Tax Certificate copy - Business ID Number - Interior design certification - W9, Federal ID form, or EIN Number - Current Business License in Design-based business

Should Tower Lighting charge you Sales Tax?

If you intend to purchase merchandise for resale, you will be required to supply a Resale or Sales Tax Certificate. Without this documentation, sales tax will be applied to all orders.

Online payments may be subject to a credit card processing fee. I understand I can choose to pay by check to avoid this fee. *

I agree

I have read and understand the Terms of Sale set forth for the purchase of lighting fixtures from Tower Lighting (https://towerlighting.com/pages/terms-and-conditions). *

I agree

Signature

DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

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We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Trade Account Information

Company Information

Company Members

CREDENTIALED DESIGN PROFESSIONAL DOCUMENTATION MUST BE CURRENT AND ACTIVE

Thanks for getting in touch!

Thanks for getting in touch!

Trade Account Information

Company Information

Company Members

CREDENTIALED DESIGN PROFESSIONAL DOCUMENTATION *MUST BE CURRENT AND ACTIVE*

Thanks for getting in touch!

Thanks for getting in touch!

CREDENTIALED DESIGN PROFESSIONAL DOCUMENTATION MUST BE CURRENT AND ACTIVE

Tiburon Copper Gas Lantern - Steel Wall Mount