Fill Out a Form NEW DEALER ACCOUNT ACTIVATION Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Activation Date *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Company Information Company Name *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeWebsite / URLPhone Number *Fax PhoneDiscount Agreement for StartupsAdditional NotesShowroom LocationClick here if the showroom address is different form the business addressShowroom AddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeWarehouse Location Click here if the warehouse address is different form the showroom addressWarehouse AddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeIs the showroom accessible by semi-truck?YesNoIs the warehouse/shop accessible by semi-truck?YesNoReceiving hours for Semi-TruckWill they require to have orders palletized?YesNoWho needs to receive delivery list?Accepts Currier Deliveries?YesNoIs there a different address for UPS deliveries?YesNoProvide additional address for UPS deliveries:Address Line 1Address Line 2CityState / Province / RegionPostal CodeDoes this dealer have multiple locations? YesNoIf yes, please submit this form again for each location. For this location, please confirm shipping address and hours for Semi-truck and UPS deliveries.Contact InformationPlease include each business contact in a new line Contact Name *Contact Position (State if they are designer, designer assistant, design manager and note if they should have access to DPP and Account Receivable Reports) *Please list how you would like them set up in DSSContact Email Address *Contact Phone *Account Set UpEmail Address for Invoices *Private Labels *AlluraCynergiBurton AllenDreamroomsFinaSorrentoTaloraZonavitaDoor BuilderYesNoDecor Branded MultiplierZonavita MultiplierDecor Dealer Type *Decor Dealer TypeA-FRIA-THUA-WEDA-TUEB-FRIB-THUB-WEDB-TUEC-FRIC-THUC-WEDC-TUED-THUD-WEDD-TUEE-THUE-WEDZonavita Dealer Type *Zonavita Dealer TypeABCDDoes the dealer require material surcharge? *YesNoDoes the dealer require fuel surcharge? *YesNoDoes the dealer require Ontario special rules? *YesNoCheck all that applies *MDT and POSMDT No Charge12"D Cabinets changed to 13" D Cabinets for Decor13.875"D Accessories12.25"D APG15"D Cabinets Changed to 16"D Cabinets11.5"D ShelvesDealer Development Specialist *Dealer Development SpecialistBev McGillBonnie FerrisMick PayneRodney HicksSteve FriesenVilas VijayCustomer Solutions Representative *Customer Solutions RepresentativeAlaka PillaiAyodeji OlorunsinaCharrybel VillalobosCraig GeakeDana MohamedJake BlatzLisa DyckMonica RodriguezPauline BuhlerRenata HonorioRuth HiebertSalena WaldnerVanessa PopeVanessa Stroparo SilvaVilas VijayWanda StoeszWhat design software is used?Industry experienceFirst Year Projected SalesFive Year Projected SalesUpload Door Sample List (22 total) Drag & Drop Files, Choose Files to Upload Accepted file types: .pdf, .png, .gif, .jpg, .doc, .docx, .xlsx, .xlsm, .xlsDealer Agreement Drag & Drop Files, Choose Files to Upload Accepted file types: .pdf, .png, .gif, .jpg, .doc, .docx, .xlsx, .xlsm, .xlsWebsiteSend New Dealer Activation Notification
