Apply For An Account

Apply for an account with Urbia or submit any questions below.

We'll do our best to get back to you as soon as possible!

Your Name

Your Title

Your Email

MAILING ADDRESS

Mailing Address

Address Line 2

City

State

Zip Code

Phone Number

SHIPPING ADDRESS

Same as Mailing Address

Shipping Address

Address Line 2

City

State

ACCOUNT INFORMATION

Subject

Question/Comments

Attach Resale Certificate

PORTAL EMAIL ADDRESS: Please provide an email address that you and your colleagues will share to access your Partner Portal; our system allows us to assign one email address per partner.

To install this Web App in your iPhone/iPad press and then Add to Home Screen.

APPLY FOR AN ACCOUNT

COMPANY INFORMATION

MAILING ADDRESS

SHIPPING ADDRESS

ACCOUNT INFORMATION