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BECOME A DEALER
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Become A Dealer

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Become A Dealer

Authorized Dealer Application Form

Legal Company Name *
Do you operate under a different trade name (DBA - Doing Business As)? *
DBA Name *
Business Address *
City/ State/ ZIP Code *
Phone Number *
Email Address *
Website *
Year Company Was Established *
Full Name *
Job Title *
Direct Email *
Mobile Phone *
Do you offer garage door installation services? *
Do you have certified technical personnel? *
Number of active employees *
Service areas (ZIP codes or counties) *
Do you have a showroom? *
Specify Location *
Do you offer products or installation services for other types of doors? *
What percentage of your total sales are garage door-related? *
Do you currently hold a valid insurance certificate? *

AA Impact Garage Door Inc. requires all dealers to have a current contractor license on file in states where required.

Contractor License Number *

NOTICE

By submitting this application, you authorize AA Impact Garage Door Inc. to use the information provided solely for evaluating your eligibility as an Authorized Dealer. All information will be handled with strict confidentiality and in accordance with applicable data protection laws.

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