Become a Dealer - WeldTec Designs

Dealer Application

Please fill out this form completely and clearly. All information will be held in the strictest of confidence.

Please note: Dealer accounts are reserved for businesses that maintain stocking orders of WTD products or have sales of no less than $10,000/month. These strict guidelines insure that our kits will not be undersold to competitors in your area.

If you are interested in becoming an approved installer of WTD products, this does not require a monthly purchase agreement.

Company Name *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number *

Website / URL

Email *

Confirm Email

Business Type *

Years In Business *

Owners Name *

First

Last

Sales Manager

First

Last

Purchasing Agent

First

Last

Inquiry Type *

Types of Products Sold *

Van
RV
Other

Expected Purchases

Selected Value: 10000

Frequency

Monthly
Yearly

If in CA, State Resale License # *

Sales Types *

Retail
Mailorder
Internet
Distributor

References (List 3) *

Signature

Name *

First

Last

Title *

Date *

Updating preview…