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Dealer Application
You may type as much as needed in each field.
Enter Your Name (Required)
Enter E-mail where we can reach you (Required)
Your Address
City
State
Residence Phone
Cell Phone
Company Name (The Preferred or Future Name)
Company Address
Company City
Company Zip
Company Phone # (Answered as a dedicated business line)
Company Email
Company Web site Address
Years of experience with detectors?
Which Brand(s) are you interested in becoming authorized for?
List any manufacturer you're currently authorized for
Business to be conducted by: Retail store, Home based, Internet, Other? (Enter as many as needed)
Tax resale #
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