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New Dealer Submission

COMPANY INFO

Company/Store Name:

[field id="company_store_name"]

Store Type:

[field id="store_type"]

Federal Tax ID:

[field id="fed_tax_id"]

Store Address:

    [field id="address_1"]
    [field id="address_2"]
    [field id="city"], [field id="state"]
    [field id="zip_code", US]

CUSTOMER INFO

First Name:

[field id="contact_first_name"]

Last Name:

[field id="contact_last_name"]

Email:

[field id="contact_email"]

Phone:

[field id="contact_phone"]

Website:

[field id="website"]

QUALIFICATION QUESTIONNAIRE

Do you also sell online?

[field id="do_you_also_sell_online"]

Do you give or host product demos?

[field id="do_you_give_or_host_product_demos"]

What type of wood pellets do you retail?

[field id="wood_pellet_types"]

How do you promote your wood pellet products?

[field id="how_do_you_promote"]

Are you affiliated with any co-ops or buying groups?

[field id="coops_buyinggroups"]

Do you have multiple locations?

[field id="multiple_locations"]
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