First Name

Last Name

What is your email address?

Name of Company

Title

Select Your Country Select Your Country Canada US

Business Phone

Please provide a company website link, company social media link, or upload a business card that includes the applicants name.

Select the country you primary ship to: Select the country you primary ship to: Canada US Both

Please provide a name of the professional design association to which you belong and your membership number.

Please provide a copy of your Business License/Resale Certificate Choose FilesNo Files ChosenAccepted file types: jpg, jpeg, jpe, png, pdf. Max. file size: 195 MB

Which of the following best describes your job role? Which of the following best describes your job role? *ArchitectContactorInterior DesignerOther

Upload Business Card Choose FilesNo Files ChosenAccepted file types: jpg, jpeg, jpe, png, pdf. Max. file size: 195 MB

Which of the following best describes your place of work? Which of the following best describes your place of work?Architecture FirmInterior Design FirmReal Estate DevelopmentOther

How many employees work at your firm? How many employees work at your firm?0-34-1011-2526+

On average, what is your firm's average annual spend on furnishings? On average, what is your firm's average annual spend on furnishings?$25,000 - $100,000$100,000 - $500,000$500,000 - $1,000,000>$1,000,000

How did you hear about the Timeless Furniture Trade Program? How did you hear about the Timeless Furniture Trade Program?Web SearchSocial MediaTrade ShowWord of MouthOther

Who Referred You?