New Dealer Application - Fold-a-Cover Tonneau Covers

Dealership Information

Note: This application is intended for brick & mortar retail dealers and does not authorize the sale of Fold-a-Cover products through any internet stores or online auction sites.

Dealer Name*

Contact Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Federal Tax ID# or Resale Tax#*

Website

Fax

How many locations do you have?

Additional Retail Locations

Name	Address

Additional Business Information

What type of business are you?

Truck Accessory Retail
RV Dealer
Auto Parts Retail
Vehicle Restyle/Converter
Detail/Body Shop
Truck Cap Dealer

How many years have you been in business?

What other tonneau cover brands do you currently carry?

Brand Name	Product Description

Who are your principals or corporate officers?

Name	Address	Phone

Where do you purchase these items from?

Manufacturer
Distributor
Other

Do you have a show room?

Yes
No

What is the square footage?

Please enter a number greater than or equal to 0.

Do you have installation facilities?

Yes
No

How many bays?

Please enter a number greater than or equal to 0.

How many installers?

Please enter a number greater than or equal to 0.

Do you advertise your business?

Yes
No

If Yes, what media do you use most frequently?

Newspaper
Radio
TV
Direct Mail
Sponsorship
Internet
Word of Mouth
Other

Electronic Communication Agreement

Steffens Enterprises, Inc. has implemented a paperless system for acknowledgements, advanced shipping notifications and invoices. These documents are now available to you via e-mail.*

Please provide electronic contact information for the appropriate documents in the spaces below. If you do not wish to receive an order acknowledgement or advanced shipping notification, please check the box indicating your preference.

I acknowledge that all future acknowledgements, advanced shipping notifications and invoices will be received via email.

Invoice email address*

Would you like to receive acknowledgement emails?*

Yes
No

Acknowledgement email address

Would you like to receive advanced shipment notification emails?*

Yes
No

Shipment notification email address

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Phone

This field is for validation purposes and should be left unchanged.