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Dealer Application

Carry Ground Systems Research. Fill this out and we'll review it and get back to you.

01BusinessBusiness name *Type of business *Years in business *Website

Retail storefront? * Yes No

02Primary contactName *Title *Email *Phone

03AddressesBilling address * Shipping address is the same as billing

04Additional contacts Optional. Added to your account.NameEmailNameEmail

05Tax

Taxable? * Yes No

Tax ID number *

Please email a copy of your resale or tax-exemption certificate with your application.

06Agreement

Payment details aren't collected on this form. You'll set up payment securely with your first dealer order.

I/we understand that invoices are due and payable on the terms agreed upon, and agree to the program terms, including the MAP policy and $250 minimum order. *Signature (type full name) *Title *

Submitting opens your email app with the completed application addressed to contact@groundsystemsresearch.com. Attach your resale certificate and storefront photo before sending.