You will need a credit applicaiton to fill out the form. CLICK HERE if you need to download a credit application and fill it out.New Dealer ApplicationStep 1 of 520%Dealer (Business) Name(Required)Main Contact Name(Required) First Last Main Contact Email(Required) Phone(Required)CellFaxAddress(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Sales and ServiceDealer PrincipalSales People Add RemoveProvide the first and last name of your current sales staff. Click the + sign to add more.Service Manager(Required)First and Last nameOther Relative Emails. Add RemoveProvide other emails you feel are relative or that we might need. Click the + sign to add more.Business InformationType of Business(Required) Corporation Partnership Proprietorship# of Years in Business(Required)# of Service Techs(Required)# of Service Trucks(Required)# of Installers(Required)State Certiicaiton #(Required)EPA Certiicaiton #(Required)Financial InformationTotal Annual Sales/Revenue(Required)% Residential New ConstructionRough percentage of annual sales/revenue that is Residential New Construction.% Residential ReplacementRough percentage of annual sales/revenue that is Residential Replacement.% Residential ServiceRough percentage of annual sales/revenue that is Residential Service.% Commercial New ConstructionRough percentage of annual sales/revenue that is Commercial New Construction.% Commercial ReplacementRough percentage of annual sales/revenue that is Commercial Replacement.% Commercial ServiceRough percentage of annual sales/revenue that is Commercial Service.Annual Equipment Purchases Total(Required)Brand Breakdown by $ Add RemovePlease list the brand and the amount spent on each brand. If you need to add multiple brands please click the + to add more lines.Credit & Statement UploadsCLICK HERE if you need to download a credit application and fill it out.Please attach a completed Credit Application(Required)Max. file size: 256 MB.Please attach a Finacial Statement(Required)Max. file size: 256 MB.This would include last year's annual balance sheet and profit and loss report.Please Select your Territory ManagerJohn SmithSam WaltonJason HamerPost Custom Field
