Dealer Application

Please fill out the form below to apply to be a dealer. All fields are required and must be filled out accurately, the upload is for a copy of your business license (this can be in the format of pdf, doc, docx, tif or jpg). Once approved, your first order must be minimum $2,500 to buy into the dealer network.

Company Name

Name

Email

Address

City

State

Zip Code

Phone Number

Tax ID

Business License