Skip to main content
Cart

Your cart is Empty

Wishlist

Your wishlist is Empty

Registry List
1Choose the Type of Account Application
Type of Application (Check One):
  •  
  •  
 
  •  
  •  
* Field is required.
2Individual Applicant Information
Billing Address is the same as the Mailing Address:
Own Home
  •  
  •  
2aCo-Applicant Information
CoApplicantDriversLicenseExpYear
  •  
  •  
3Individual Applicant Employer Information
3aCo Applicant Employer Information
4Individual Applicant Bank Information
5Individual Applicant References
Has Applicant (Co-Applicant) ever declared Bankruptcy?
  •  
  •  
6Previous Store Credit
Has Applicant (Co-Applicant) ever been extended credit through any Galena Furniture Warehouse Store?':*  
Has Applicant (Co-Applicant) ever been extended credit through any Cheap Furniture Direct Test Store?
  •  
  •  
If Yes, Which Store?
7Disclaimer and Signature
(By typing your name in this box, you are Legally signing this Document)
(By typing your name in this box, you are Legally signing this Document)
8Select the Closest Store to Your Location