Account Type
Account Details

New Customer Application

We looking forward to building a beautiful business partnership with you! Before we do that, we will need a few days to review your new customer application. To check on the status of your application, please feel free to give our Wizards of WOW a call anytime at 1 800 263 2322.

About You

Company Name *
First Name *
Last Name *
Phone # *
Fax #
Email Address *
Acknowledgement Email (if different from Email)

Billing Info

Street Address *
City / Town *
Country: Province / State *
Zip / Postal Code *
Phone Number
Hours Of Operation
Invoice Email (if different from Email)
Statement Email (if different from Invoice Email)
Payment Preferences *
Credit Card

Store Locations

Street Address *
City / Town *
Country: Province / State *
Zip / Postal Code *
Phone Number
Hours Of Operation

Business Details

Type Of Business
Custom Framer
Interior Design
Furniture Store
Lifestyle & Home Décor Store
Gift & Accessory Store
If Other Please Specify
Do You Have a Storefront?
Yes No
Annual Sales Volume *
Do you Display Corner Samples?
Yes No
Number Of Store Locations
Do You Offer Custom Framing?
Yes No
Additional Notes

I consent to the obtaining of bank/credit and/or personal information as may be required at any time in connection with the credit hereby applied for or renewal or extension hereof and to the disclosure of the credit information concerning me and/or my company to any credit reporting agency or to any person with the undersigned who has or purports to have financial relations. I further acknowledge that " Title of Goods " remains with the credit grantor even though goods may be in transit and/or on customer's premises ( in case of resale ), until payment has been received in full. I am obliged to inform Roma in writing of any changes in the legal name and form of the company. Failure to do so will permit Roma to continue to deal with the undersigned in the form as noted on this credit application. I have read and agreed to abide by Roma's current Terms & Conditions of Sales. I hereby certify that the information contained in this application is true and correct. All information, including credit card numbers, will be kept confidential and not shared with third parties.