Trade Account Registration

Bellini Modern Living is a trade-only company exclusively supplying furniture retailers, design firms, and wholesalers. Please complete the registration form below. Once submitted, a member of our sales team will review your application and contact you within seven business days.

Business

Contact

Addresses

Consent

Business Information Step 1/4

Where Are You Located? *

How long have you been in business?

Operating Name

Legal Business Name *

Website

Socials

What Type of Business Are You? *

Number of stores or offices

Contact Information Step 2/4

Primary/Buyer Contact

First Name *

Last Name *

Phone *

Email *

Job Title

Billing & Shipping Step 3/4

Billing Address

Company Name *

Billing Phone

Address Line 1 *

Address Line 2

City *

Province / State *

Country *

Postal / Zip Code *

Business Registration Number (BN for Canada / EIN for U.S.)

Tax Registration Number (GST/HST for Canadian businesses, EIN/Federal Tax ID for U.S. businesses, or your country’s business tax/VAT number)

Shipping address same as Billing address

Note: Deliveries are limited to dock-level commercial locations only.

Shipping Address

Company Name

Shipping Phone

Address Line 1

Address Line 2

City

Province / State

Country

Postal / Zip Code

Add additional contact

Consent Step 4/4

Have you placed an order with Bellini Modern Living before?

How did you hear about us?

If other, please specify

I agree to the terms & conditions

Trade Account Registration

Primary/Buyer Contact

Billing Address

Shipping Address

Additional Contact

Submitted successfully!

Trade Account Registration

Primary/Buyer Contact

Billing Address

Shipping Address

Additional Contact

Submitted successfully!

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