Menu

Home
Shop
Custom Design
Wholesale Program
Consignment Program
About
Contact

$0.00

Credit Application

Business Information

Business Name:

DBA (if applicable):

Business Address:

City:

State:

Zip:

Phone:

Email:

Website:

Business Type:

CorporationLLCSole ProprietorPartnership

Year Established:

Resale/Tax ID #:

Billing Information

Billing Contact Name:

Billing Address (if different):

Billing Phone:

Email:

Preferred Payment Method:

ACHCredit CardCheck

Do you require a PO number on invoices?:

YesNo

Business Information (Continued)

Primary Buyer Name:

Buyer Phone:

Email:

Number of Store Locations:

Average Monthly Jewelry Spend: $

Do you sell online?:

YesNo

If yes, list URL(s):

Bank Reference

Bank Name:

Bank Address:

Bank Contact:

Phone:

Account Number (last 4 only):

Trade References

Please list 2-3 vendors you have credit terms with:

1.

Vendor Name:

Phone:

Contact Name:

Email:

2.

Vendor Name:

Phone:

Contact Name:

Email:

3.

Vendor Name:

Phone:

Contact Name:

Email:

Terms & Authorization

By signing below, I certify that the above information is true and correct. I authorize Maddie V Designs to verify all references and obtain a credit report if necessary. I understand that invoices are due Net 30 unless otherwise stated, and unpaid balances may be subject to late fees or collections.

Authorized Signature:

Printed Name:

Title:

Date:

Amore Lux offers multiple ways to experience our consciously curated luxury jewelry.

We love networking and are excited to now offer consignment and wholesale options!

Send a request for more info and let’s chat!

Facebook Instagram

Quick Links

Custom Design
Credit Application

Privacy policy
Terms and Conditions