Dealer Application

Step 1 of 5

20%

Company Name(Required)

Contact Person's Name(Required)

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Website

Disclaimer(Required)

I Understand and Agree to the terms listed in this form.

DISCLAIMER: You must have a full time, commercial, motorcycle, business. Shop cannot be in your home or attached to your home. You will be heavily stalked so please don’t waste your time or mine, if this is not what you do for a living.

Business Details

Tax ID(Required)

Years in Business(Required)

Authorized Purchasers(Required)

Please list any persons you authorize to make purchases, from Cycle-Rama Inc., with your account.

Trade References

Please upload most recent Drag Speciality( Parts unlimited, LeMans) Statement if you have an account with them

Client Name(Required)

Contact Person(Required)

Phone(Required)

Please include the country code with the phone number. e.g. +1 555-555-5555

Contact Person(Required)

Client Name(Required)

Phone(Required)

Please include the country code with the phone number. e.g. +1 555-555-5555

Shop / Store Requirements

Please check all boxes to continue(Required)

Company has a retail store / Installation Facility

Please check all boxes to continue(Required)

Company is separate from the owners primary residency and not on the same property as the residency.

Contractual Terms and Conditions

Legal and Contractual Requirements(Required)

We agree to be compliant with Contractual Agreements and Non-Disclosure Agreements

Ability to Comply with Contractual Obligations(Required)

We confirm that we hold a valid state business license and tax certificate

Terms and Conditions(Required)

We understand the terms and conditions outlined above and can confirm that we meet all legal and contractual requirements as stated

File Upload

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 128 MB, Max. files: 9.

Please upload all required documents. For example : Business license, Sales and Use certificate, Drag Specialties Invoice.

Disclaimer(Required)

I Understand and Agree to the terms listed in this form.