Emporium Italy Wholesale

Retailer Form


Please fill out this form in all its parts.

* Obligatory fields

My address:
* First Name: * Last Name:
* Address:
* City:   * State/province:
* Zip Code: * Country:  
Company   
Type of business you are in


Contact information:
Contact person
* E-mail address:
* Home Phone:
Best time to call me: my local time
Work Phone:
Best time to call me: my local time
Fax:

 
TYPE OF PURCHASE
Reseller     
Corporate gifts
Retailer     
Occasion Tokens
Which articles are you most intereseted in?
Italian Charm Bracelets
Murano Glass
Murano drinking glasses
Murrina accessories
Marble Chess chess
Antique pistol replicas
Nao by Lladro
Artistic Plates
Crystall Ships

 Capodimonte
Cellarosi Ceramics
Venician Maskes
G. Barbetta sculptures
Glass clocks
Jewelry
Festina Watches
Arte Povera ceramics
D&G Watches

Payment by credit card:
Cards accepted:
Full name on card: Card Number :
Expiration date: Month Year

I would like to give my credit card details over the phone:

Please call me at this phone number:
Best time to call me: my local time

Ordereing Directly:
Minum order: 10 assorted peices.

I would like to order these following articles now:

Credit Card charging:
Your credit card will be authorized by your credit card company and then be charged for the Total Amount (article price + mailing cost) specified in this previous page according to your country area:
Area USA or Area Europe.

Order Confirmation:
Within the next 24 hours you will be receiving a Confirmation mail from Emporium Italy at your e-mail address stating: Article ordered, Article price, Mailing cost, Days delivery, Credit Card Authorization
Status, Total amount charged, day parcel will be mailed out to you.

Please insert eventual information, requests or questions:

Wholesale Pricing: Once you have filled out the Merciant info form you will be sent the discount that will applys to each catagory of goods plus discount related to the quantities intented to be puchased. I will e-mail you back within 24 hours with the discount infomation.