Initial Dealer Application
Business Information
What type of business?
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Skating Rink
Skate Shop
Sporting Goods Store
Online Retailer
Other
If you put other please describe your business.
Legal name of your business?
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Name of parent corporation?
Under what name is your business run?
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How many years have you been in business?
*
What country is your business located?
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Phone Number
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-
Area Code
Phone Number
Email
*
example@example.com
Federal Tax ID#
*
Mailing Information
Where do you want your mail to go?
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Where do you want your orders to be shipped?
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is your shipping address residential?
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Yes
No
Building Information
Physical address of your business
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have a storefront?
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Yes
No
If so , is it used solely for business purposes?
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Yes
No
If not solely used for business, please list other purposes.
Owner Information
Please provide information about the owner or owners of the business. (if only one owner please fill out fields marked (1)
Name (1)
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First Name
Last Name
Phone Number (1)
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-
Area Code
Phone Number
Residential address (1)
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name (2)
First Name
Last Name
Phone Number (2)
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Area Code
Phone Number
Residential address (2)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name (3)
First Name
Last Name
Phone Number (3)
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Area Code
Phone Number
Residential address (3)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Historical Information
Who is your Primary Roller-Skate distributor?
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What is your account number with them?
What is their phone number?
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Area Code
Phone Number
Payment information
Who is responsible for making payments?
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First Name
Last Name
Who is authorized to make purchases?
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How do you wish to pay for shipments?
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COD-Cash
COD-Check
Visa
MasterCard
AMEX
Additional Items Required
Copy of your business license issued in the name of the company for which this application is being made
Copy of your business license.
*
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Copy of your sales-tax-&-use certificate (may be apart of your business license).
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Terms of sale
Southeastern Skate Supply of GA, inc. , is a wholesale distributor of roller skates and skate supplies. Terms for new dealers are as follows: (1) all orders are shipped COD-Cash unless arrangements for other payment have been made. In the event that a shipment is returned to us, the dealer is responsible for the shipping costs incurred by the attempt to deliver plus a $5 per box return fee plus any applicable restocking fee, and further shipments may be held until the outstanding balance is paid. We publish a price list twice a year, but prices are subject to change at any time without notice. Warranties are offered only by the individual manufacturers, who reserve the right to repair instead of replacing any defective merchandise; warranties do not cover any shipping costs. All returns must be made within 30 days of purchase and must be accompanied by a copy of the original invoice or picking ticket. We cannot accept the return of mounted skates or of boxes which have been marked on. All Items accepted for return will be assesed a 20% restocking fee. Until you hear otherwise you are CASH-only. We reserve the right to change these terms at anytime.
I have read and understand the Terms Of Sale
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Yes
Dealer Agreement
I/We certify that the information submitted in connection with this application is true and correct and that I/we have read and understand the above terms of sale, and agree that such terms apply to all transactions. I/We further agree to serve notice by certified mail, return receipt requested, of any changes in ownership or legal structure of the business. Southeastern Skate Supply of GA, INC., shall not be affected by such change until receipt of written notice of such change from applicant.
I have read and understand the Dealer Agreement.
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Yes
Date
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-
Month
-
Day
Year
Date
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