Dealer Application Form

Company Name *

Address *

City *

State / Province *

Zip / Postal Code *

Phone Number *

Fax *

Email *

Confirm Email

Website *

Person to Contact (and other key people) *

What e-mail address do we send invoice/ statements to *

Federal Tax ID# *

Annual Gross Volume *

% Builder *

% Retail *

Present Lines Carried *

Sold Most and Why *

Showroom Size *

Warehouse Size *

Number of Inside Sales People *

Number of Outside Sales People *

Number of Office Staff People *