New Dealer Application - United States

Thank you for your interest in becoming one of our dealers. Please fill out the requested information and we will contact you with additional information.

For fields requesting photographs, if unable to upload on the form you may attach them to an e-mail and send them to sales@eagledist.com

Requested Information
Please provide your sales tax certificate number. This is sometimes the same as your business license number.
Please upload a photo of your retail sales area
Please Upload a photo of your track(s), if your track is not yet complete, please leave a note below with the track builders name and contact information.
Please list any additional personnel you authorize to place orders, please include name, telephone number and e-mail address.
Please Type your first and Last name
I UNDERSTAND THAT CHECKING THIS BOX CONSTITUTES A LEGAL SIGNATURE CONFIRMING THAT I ACKNOWLEDGE AND AGREE TO THE TERMS AND CONDITIONS
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