Dealer Registration

Company Name *

DBA (optional)

Date Established *

Federal Tax ID# *

DUNS (optional)

Tax Exempt *YesNo

Legal Structure *CorporationLLCPartnershipSole Proprietorship

Phone *

Fax (optional)

Website (optional)

First Name *

Last Name *

Title *

Sales Rep # (optional)

Tax Exempt Certificate

Email *

Business Area *Law EnforcementMilitaryTrainingCivilianOther

Market Presence *StorefrontRetail WebCatalogGSA Contract

Why do you want to become a dealer? *

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