Maui Whitening Dealer Application

Maui Whitening Dealer Application

Kindly complete the form provided below to apply for the reservation of an exclusive Maui Whitening dealer territory and to pursue becoming a Maui Whitening Dealer. We appreciate your commitment to this endeavor and request that only those genuinely interested in becoming a dealer proceed with the application. It is important to clarify that this application serves as a formal step toward reserving a territory and initiating the dealer process; it is not merely a request for additional information. Additionally, filling out this form does not entail any legal obligation to purchase a territory.
Full Name*

First NameLast Name
Your Mobile Number*
Please enter a valid phone number.
E-mail*
example@example.com
With my Maui Whitening Dealership, I plan to:*

Set up my teeth whitening business as a stand-alone new business.Set up my teeth whitening business inside a current business I already have.Set up my teeth whitening business inside another new business that I am starting (ex: med spa, etc.).
If you intend to establish your Maui Whitening Dealership within an existing business that you own, kindly provide details about your current business. Please be aware that this does not apply to individuals seeking to set up their dealership within a booth rent salon. This request specifically concerns those who own an existing business.
Dealership Selection

Choose the dealership below that you are seeking to apply for. Please be aware that you will not be making any payments for a dealership today. This selection is solely to inform us of your preferred dealership for your application.

Single Station Maui Whitening Dealership Product Image

Single Station Maui Whitening DealershipMaui Whitening Single Dealer Station includes (1) professional teeth whitening laser, (1) shade guide, (1) mouth model, (2) bib clips, Maui Whitening Pre-Rinse, Maui Whitening Teeth Whitening Customer Kits, Maui Whitening Laser Gels, Access to Maui Whitening Product and Equipment Online Certification Course and Assessment, Maui Whitening Certification Workbook, LIVE Demo Training Pass

$2,749.00 Quantity
Item subtotal:$0.00

Double Station Maui Whitening Dealership Product Image

Double Station Maui Whitening DealershipMaui Whitening Double Dealer Station includes (2) professional teeth whitening laser, (2) shade guides, (2) mouth models, (2) bib clips, Maui Whitening Pre-Rinse, Maui Whitening Teeth Whitening Customer Kits, Maui Whitening Laser Gels, Access to Maui Whitening Product and Equipment Online Certification Course and Assessment, Maui Whitening Workbook, LIVE Demo Training Pass

$3,999.00

Triple Station Maui Whitening Dealership Product Image

Triple Station Maui Whitening DealershipMaui Whitening Triple Dealer Station includes (3) professional teeth whitening lasers, (3) shade guides, (3) mouth models, (3) bib clips, Maui Whitening Pre-Rinse, Maui Whitening Teeth Whitening Customer Kits, Maui Whitening Laser Gels, Access to Maui Whitening Product and Equipment Online Certification Course and Assessment, Maui Whitening Workbook, LIVE Demo Training Pass

$5,249.00 Quantity

Dealership Shipping / Freight Fee (one time fee)

$120.00 Quantity

Enter coupon

Total

$0.00

EXCLUSIVE TERRITORY REQUEST
At Maui Whitening, we believe in fairness and transparency when allocating exclusive territories to our dealers. That's why we base these territories on county size, ensuring they are proportionate to the potential customer base in each area. To determine the population size of your desired county, we recommend using Google search or other reliable sources. Once you've identified the population size, please select the corresponding option below. Our monthly supply subscription amounts are then tailored to the population size, providing a minimum supply for fresh supplies, with the flexibility to order additional kits separately if needed. Please view the PDF above to view the Dealer Exclusive Territory Pricing Guide or you can copy and paste this link in a new window to view the PDF - https://bit.ly/3x3SnlH *
(OPTIONAL) I would like to add on an additional county that is adjacent to my Primary County to expand my territory size. I would like to select the following county size below. (Please note, if you want to add on more than one additional county, you can request that on the Dealer Phone Call.) If your county has more than 1,000,000 people, please select the 3rd option and we will discuss on the Dealer Call. (Leave this section blank if you are not adding on an additional county at this time.)
PRIMARY COUNTY TERRITORY REQUEST: I am applying for the following
Primary County Type a label*
in the state of Type a label* .
ADD-ON COUNTY TERRITORY REQUEST: (Optional)
Add-On County Type a label
in the state of Type a label .
Dealer Verification Phone Call

Please schedule a brief phone call to discuss your Dealer Application. Please note, this call will not involve any sales pitches. Our sole aim is to verify your information, discuss your dealer application and your exclusive territory request by county. The call is expected to last approximately 15- 20 minutes, or longer if you have any questions for us.
Appointment*
Kindly share with us your reasons for believing that you would excel as a Maui Whitening Dealer.*
If you have additional questions or comments, let us know here.
Additional People

Please tell us if there are any other people you want to add as certified dealers to your dealership. For example, a spouse, adult child, etc. These are people that would be working in your business and have ownership in your dealership. Please list below. Leave blank if you will be the only dealer.
Name

First NameLast Name
Name

First NameLast Name
Submit Dealer Application

By submitting this dealer application, I understand that I am not committing to a legally binding agreement to purchase. Instead, I am expressing my serious interest in purchasing and continuing with the Maui Whitening dealer application process. I acknowledge that it is expected for me to participate in the dealer phone call that I scheduled at the date and time above, after submitting this application. I understand that an executive from Maui Whitening will call me at the number listed on my application at the date and time that I scheduled. If I fail to attend the scheduled Dealer Call, Maui Whitening reserves the right to decline rescheduling.
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Maui Whitening Dealer Application

Dealership Selection

EXCLUSIVE TERRITORY REQUEST

Dealer Verification Phone Call

Additional People

Submit Dealer Application