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Dealer Application

Please fill in this form and submit it to us. We will send you a username and password within 2-3 business days.

Business Name:		Telephone:
Mailing Address:		Fax:
		E-mail:
		Website:

Shipping Address:	Same as mailing address




Business Type:	Sole Proprietorship Partnership Corporation
Owner(s) Name:
Owner(s) Address:



CDN Businesses only
GST #:		PST #:
US Businesses only
Tax ID:		State ID:
3 Trade References: (Name, Address, Telephone)
Reference 1:		Reference 2:





Reference 3:





How long have you been in business?

What is the nature of your business?

I have read the Dealer Policy Agreement and agree to its terms.