Wholesale Dealer Application
Company Name
*
Primary Contact Name
*
First Name
Last Name
Primary Business Activities (Select all that apply)
*
Retailer with store front
Service dealer
Online retailer
Rental business
Ebay store
Amazon store
Other
Website URL
eBay Username
Amazon Username
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Delivery Address (if different than above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Telephone
*
Format: (000) 000-0000.
E-mail
*
Business Type (Corporation, Partnership, etc.)
State Resell Number
Please upload your reseller certificate
Browse Files
PDF, JPG, PNG file
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Trade Reference
List a Powersports Distributor you do business with.
Company Name
Account # or Contact
Applicant Signature
*
Type in your full name here. It will serve as your signature.
Date Signed
-
Month
-
Day
Year
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