Online Application to Open a Retail Account

Exaclair, Inc. is the exclusive U.S. distributor of Clairefontaine, Exacompta, Rhodia, Quo Vadis, G. Lalo, Brause, J. Herbin, Mignon and Decopatch products.


		OPEN A RETAIL ACCOUNT

		INTERNATIONAL CONTACTS

		Visit our other web sites:

		Quo Vadis

		Rhodia

		J. Herbin

		ExaclairRetailers

		Visit our blogs:

		Rhodia Drive

		Quo Vadis Blog


	Home > Contact Exaclair > Open a Retail Account > Online Application

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Online Application to Open A Retail Account

Please complete and click the submit button. * required

If you have any questions or need assistance, please call 1-800-933-8595, Ext. 116,
or send us an email.

1. Company Name

2. D.B.A.

3. Resale #

4. Fed Tax ID #

5. E-mail Address

6. Billing Address


Billing Street Address

City	State	Zip

Phone Number *	Fax Number

7. Shipping Address


Shipping Street Address

City	State	Zip

Phone Number	Fax Number

8. Retail Location

Click box if same
as Shipping Address:


Retail Location Address

City	State	Zip

Phone Number	Fax Number

9. Website

Do you sell online?
Yes No

9b. Blog URL

10. Store Description

11. Years in Business

12. Business is a:

	Sole Proprietorship
	Partnership
	Corporation

13. Company Owner

14. Authorized Buyers

15. Partners

16. Method of Payment

	Net 30
	Credit Card

In order to be eligible for terms, please complete the following:

17. Trade References (three required, i.e. companies with which your firm has reseller accounts):

Trade Reference #1








Account Number

Telephone	Fax

Trade Reference #2








Account Number

Telephone	Fax

Trade Reference #3








Account Number

Telephone	Fax

I accept these terms.

I/We hereby accept responsibility for invoices being paid within the stated terms. Should litigation be necessary to collect such invoices, court costs and attorneys' fees will be recovered by the prevailing party. The place of performance of this agreement and related orders shall be considered by the parties hereto to be New York, New York.

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