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Apply For An Account

Thank you for your interest in Regency International. Please complete and submit the form below and we'll get in touch with you within 1-3 business days.

**Please note: Those not already a Regency customer must provide a copy of their STATE Sales & Use Tax Certificate (or Resale License) in order for their request to be processed.

*Attention | All items available to the trade only, please contact Regency for a vendor near you. Thanks!

All fields marked with an "*" are required.

State issued Resale/Reseller's Permit
or Sales & Use Tax Certificate