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Please complete the form to create a business account with Element Designs(* required fields).

Company _*

Business Category _*

Industry _*

Website

Purchasing Contact First Name _*

Purchasing Contact Last Name _*

Title _*

Purchasing E-mail _*

Phone Number _*

Shipping Street _*

City _*

Country _*

State/Province _*

Zip code _*

Billing Address

Same as above

Street address _*

City _*

Country _*

State/Province _*

Zip code _*

Accounting Details

Same as Purchasing Contact

Accounting Contact

Accounting E-mail Address

Federal Tax ID#

Tax Exempt
Yes No

Resale Tax ID#

Will you require a lift gate to receive palletised shipments? (Additional fees may apply.)

Yes No

Notes or Special Instructions?

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Element Designs

Physical Address:
235 Crompton Street
Charlotte, NC 28273