Dealer and Distributor Application

Dealer and Distributor Application
Legal Business Name:*
DBA:*
URL:*
Physical Address:*

Street Address

CityState / Province

Zip CodeCountry
Delivery Address:*

Street

CityState / Province

Zip CodeCountry
Bill To Address If Different Than Above:

Street

CityState / Province

Zip CodeCountry
Phone:*
Cell Phone for Inventory Alerts:
By submitting this application, you grant permission for the phone number provided in the "Cell Phone" field to receive product updates via text messages. You have the option to unsubscribe at any point by replying "STOP" or by reaching out to our customer care team at orders@gameguard.net or calling (940) 464-4800.
Email Address:*
Check One:*

Sole ProprietorLimited Liability CorporationPartnershipCorporationTrust
Number of Years in Business:*
Date Business Started:*

MonthDayYear
State Incorporated:*

Street Address

Street Address Line 2

CityState / Province Incorporated

Zip CodeCountry
RFC for International Shipping:
TIN/FEIN/RFC *
Owners or Executive Officer (If There Are More Than Two, Please Attach an Additional List.)
Owner/Executive Officer
Title:*
Owner/Executive Officer
Title:
Person to Contact Regarding Financial Matters
Name:*
Email*
Title:*
Phone:*
Person to Contact Regarding Buying Decisions
Name:*
Email*
Phone:*
Please select one*

I would like to sell GameGuard in my store.I would like to sell GameGuard to corporate clients or special events
Sales Tax Exemption Certificate Attached? No Yes
Resale Certificate Attached? No Yes
Upload Sales Tax Exemption and Resale Certificate:*

Cancelof
Gross Annual Revenue:*
How many Reps do you have?*
Do you office from home or a commercial office?*

Home OfficeCommercial Office
Are you a part of a large franchise buying group?*

YesNo
Other Brands Currently Carried:*
Interests:*

FishingHuntingFarm and RanchEverydayOther
GameGuard Sales Representative
How Did You Hear About Us?*
Authorized Signature:*

Clear
Printed Name:*
Date:*

MonthDayYear
I am authorized as an officer of the company to sign and legally bind my company to the the Terms of Service and Policies disclosed at the bottom of the GameGuardPortal.com website. https://gameguardportal.com/policies/terms-of-service
Should be Empty: