World of Powersports Wholesale Parts – Dealer Application



[pic]

|World of Powersports Wholesale Parts – Dealer Application |

| |

|2635 N. 22nd Street, Decatur, Illinois 62526 USA – Tel (217) 233-1245 Fax (217) 233-0008 or (888) 273-8606 |

| |

|( Honda ( Kawasaki ( Yamaha ( Suzuki ( Polaris ( Sea-Doo ( Bombardier ( Ski-Doo( Triumph ( Arctic Cat ( |

|Company Name: |Primary Contact Name: |

| | |

|Mailing Address (Street): |

| |

|Mailing Address (City): |Mailing Address (State and Zip code): |

| | |

|UPS Delivery Address: (if different than above) |

|Telephone: |Fax Number: |

|Email Address: |Website URL: |

| | |

|Business Type: (Corp., Partnership, Etc) |State Resell Number: |

|Credit Card to be used for Orders: |Card Type: MC _______ Visa _______ |

| | |

|Card # | Exp Date: |

|Name as it Appears on Credit Card: |

|Credit Card Billing Address (Street): |

|Credit Card Billing Address (City): |Credit Card Billing Address (State and Zip code): |

|Authorization to Charge: I hereby certify that by providing the above credit card information I have authorized World of Powersports to charge this |

|credit card for any order shipped to the address shown in the above spaces. |

| |

| |

| |

|Cardholders Signature: __ _________________________________________________________________ |

|Trade Reference: (List a Powersports Distributor you do business with) |

|Company Name: |Account # or Contact: |

|Application Checklist: |

|□ Credit Card Number on Application. |

|□ Faxed Application, Credit Card Authorization & Copy of Business License to World of Powersports at 888-291-7278 |

|□ Setup User for Online ordering at & notified internet sales personnel at World of Powersports to change pricing to Wholesale |

|Prices. |

|Fax Completed Application to (217) 233-0008 or 888-291-7278 |

|Apply Online at |

|YOUR ARE APPROVED AS A DEALER ONCE YOU FAX ABOVE INFORMATION. |

[pic]

2635 N. 22nd Street, Decatur, Illinois 62526 USA – Tel (217) 233-1245 Fax (217) 233-0008

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download