World of Powersports Wholesale Parts – Dealer Application
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|World of Powersports Wholesale Parts – Dealer Application |
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|2635 N. 22nd Street, Decatur, Illinois 62526 USA – Tel (217) 233-1245 Fax (217) 233-0008 or (888) 273-8606 |
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|( Honda ( Kawasaki ( Yamaha ( Suzuki ( Polaris ( Sea-Doo ( Bombardier ( Ski-Doo( Triumph ( Arctic Cat ( |
|Company Name: |Primary Contact Name: |
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|Mailing Address (Street): |
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|Mailing Address (City): |Mailing Address (State and Zip code): |
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|UPS Delivery Address: (if different than above) |
|Telephone: |Fax Number: |
|Email Address: |Website URL: |
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|Business Type: (Corp., Partnership, Etc) |State Resell Number: |
|Credit Card to be used for Orders: |Card Type: MC _______ Visa _______ |
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|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. |
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|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. |
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2635 N. 22nd Street, Decatur, Illinois 62526 USA – Tel (217) 233-1245 Fax (217) 233-0008
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