Dealer Application

Dealer Application Form
Are you a business located in the US? Please complete our American dealer application instead.

Click here to go to our American Dealer Application

Are you a luthier? Please complete a luthier application instead to access luthier-level pricing.

Click here to go to our Luthier Application

In order for us to consider your application, you must provide a verifiable business website or brick-and-mortar business presence as well as at least one trade reference from whom you currently purchase inventory.

We only partner with music-focused retail businesses and are not able to supply general product eCommerce stores or third-party marketplace sites.

Thank you for your understanding.
Business Information
Name of Business*
Business Website*
Date Business Started*

MonthDayYear
Business GST/HST #
Business Phone Number*
Please enter a valid phone number.
Business Email*
Please enter a valid email address.
Address of Business*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Owner Information
Name of Business Owner*

First NameLast Name
Is the business address is the same as owner's home address?*

YesNo
Address of Owner*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Trade References

We require contact info for 3 companies from whom you currently purchase products.
1. Name of Trade Reference*
Phone Number*
Please enter a valid phone number.
2. Name of Trade Reference
Phone Number
Please enter a valid phone number.
3. Name of Trade Reference
Phone Number
Please enter a valid phone number.
Acceptance

The applicant agrees that the Credit Terms granted by Counterpoint Musical Services are that all accounts are due and payable within 30 days from the date of invoice unless otherwise stipulated in writing and that a service charge will be paid by the customer on all amounts beyond these terms.
Signature of Applicant*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Dealer Application Form

Business Information

Owner Information

Trade References

Acceptance