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Company Name
Company Address
Company Phone
Registered Business Number
Designer Name
Designer Email
Designer Phone

I hereby certify the information given is correct and valid. I understand that:

  1. I must be present for all purchases to receive the Designer Membership Program discount;
  2. All purchases must be paid for with my own tender;
  3. Designer Membership Program discounts are not valid with any other sale or offer;
  4. Cornerstone Home Interiors reserves the right to exclude items from the Designer Membership Program discounts at our sole discretion without prior notice to members;
  5. Cornerstone Home Interiors may revoke the privilege of the designer discount card at any time;
  6. Each member must fill out a separate application;
  7. Misuse of the membership may result in membership termination. Misuse includes without limitation: use of the trade discount for personal purchases, any resale of merchandise purchased using the trade discount through any retail outlet (e.g., resale on or through any retail or auction, website or store), transfer of membership, or allowing others to use the membership card.

Designer's Signature
Please note that this is a membership application, not a credit application.