Dealer Application

Receive Discounts with our Dealer Program

Business Name*
Do you have a Storefront?*
Sales Tax Number*
EIN #*
Business License #*
Which City?*
Delivery Address*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Buyer's Name*
Name*
First Last
Email*
Lifetime replacement on factory issues. 50% off retail for replacement on customer caused damage. If your customers have any issues with our product, we ask that you have them reach out to us directly and we will take care of them. (385) 236-3008 (CASEY)
On light whip orders of 10 or more, we ask that you place your orders well in advance so that we can ensure a timely delivery.
For your convenience, we accept major credit cards or PayPal. We do not ship COE or carry accounts. Payment is required at the time the order is placed.
Signature of owner/executive officer*
Date*