New Dealer Form

Phone Number *

Company Name *

Phone Alternate *

DBA *

Website *

EIN *

Date Established *

Physical Address *

Line 1

Line 2

City

State

Zip Code

Country

Mailing Address if Different from Physical *

Line 1

Line 2

City

State

Zip Code

Country

Commercial or Residential *

Commercial Residential

Resale Certificate or Business License *

Select image to upload:

Terms Requested *

Prepay Credit

Freight Charges *

Prepay Use Account

Account *

Fedex UPS

Account# *

market Information

Type of Business *

Market Strategy/Method of Selling *

Third Party Selling *

Amazon.com Ebay.com Other

Types of Products Sold *

# of Vendors Currently Representing *

1-2 3-6 7-12 12+

If Other, Please List *

Geographic Area Served *

Your State United States International

Trade References

Name *

First

Last

Company *

State *

Nature of Business *

Name *

First

Last

Company *

State *

Nature of Business *

Name *

First

Last

Company *

State *

Nature of Business *

Bank References

Bank Name *

Account Registration *

Type of Account *

Checking Savings

State *

Bank Name *

Account Registration *

Type of Account *

Checking Savings

State *

ElevateSUP Distributor Agreement

Company Information

market Information

Trade References

Bank References

Warranty

Dealers

Owners Manual

Accessories