Dealership Application Form
Company name
Resale #
Shipping address
Bill to address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Fax Number
Please enter a valid phone number.
General Email
example@example.com
Credit Email
example@example.com
Website
Owner's name
Buyer's name
Accounting contact name
Accounting phone
Please enter a valid phone number.
Please tell us about your business:
Company type (e.g. Sole proprietorship LLC, partnership, corporation etc.)
Total number of stores
How long in business & How long at this location
example: 5 years, 3 years
Do you own or rent?
Number of employees
Annual gross sales
Square feet
What are your main suppliers?
Rows
Name
Account #
Annual purchases
How long
1
2
3
4
What major scooter/consumer product lines do you carry?
Rows
Name
1
2
3
4
Briefly describe your business
Do you intend to sell online?
Yes
No
If yes please enter the URL of your online website
Submit
Should be Empty: