Become a Dealer

Dealer Application

Contact

Primary Contact Name *

Title/Role

Email *

Phone *

Business Legal Business Name (or Individual) *

Website *

Years in Business

Business Type *

Sales Channels (select all that apply)

Tax ID (EIN/RFC) *

Resale/Tax-Exempt Certificate Link *

Social Profiles Brands You Currently Carry

Addresses Billing Address * Shipping Address (if different)

Country *

State/Province

Program Details

Estimated Monthly Volume (units)

Do you require dropshipping?

Marketplaces you sell on

Territory / Store Locations

Store Photos / Proof of Retail (links) Anything else we should know?

Agreements I agree to the Dealer Terms & Conditions and MAP policy. I consent to processing this data per the Privacy Policy. Typed Signature *