Dealer Registration Form

Become an OPIS Authorized Dealer!

Drive Smarter, Drive Safer
Please provide all required details below to qualify your business with us. If your company qualifies to become a dealer, an OPIS representative will be in contact with you to discuss further opportunities. Thank you for your interest in the OPIS.
Business Owner*

First NameLast Name
Business Name*
Contact Number*
EIN*
E-mail*
example@example.com
Company Website*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long have you been in business?*
Type Business

DealerNew SalesUsed SalesRepair ResidentialRepair CommercialMobile RepairOther
How did you hear about OPIS?*
If Other was selected above, please specify here:
Please describe your current interest level in becoming an OPIS.*

Looking to start selling in in the next 3 monthsLooking to start in 6 monthsLooking to start in 12 monthsCurrently just researching for dealer opportunitiesReady to buy today
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Become an OPIS Authorized Dealer!