Wholesale Application Form

Electric Import Motors reseller application

Upon review you will receive an notification email.

Address

First name

Last name *

Company

Business Address *

City *

Country/Region *

Province/State/Region *

Postal code *

Email *

Phone

Business/Trading Name *

Website *

How long have you been in business *

Business Type *

Retail Store

other

How did you hear about Electric Import Motors *

Social Media Handle (Instagram, Facebook, Twitter, etc.)

Please add at least one of your social media handles.

Why do you think you and your business would be a good fit as a reseller? *

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Order products

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Order Total (The sum of all the prices of all the items in the order, taxes and discounts included.)

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Contact information

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Shipping address

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Billing address

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