New Dealers Form

The Blynd - New Dealer Info

Please include the following in your email:
(click the "Update Dealer Info" button below to generate email)

Company Info

Company Name*

Address

City

State

ZIP Code

If different - Billing Address

Full Billing Address*

Phone

FAX

Website Address

Attach Logo

Sales Tax ID Number

Contact Info

Primary Contact Name*

Primary Contact Phone*

Primary Contact Cell

Primary Email*

Accounts Payable - if different than primary contact please include below...

Accounts Payable Contact Name*

Accounts Payable Phone*

Accounts Payable Cell

Accounts Payable Email*

May we email invoices?

Note or Comment

New Dealer Info

Notice: Sales Territories and Authorized dealers are determined exclusively by Franks Manufacturing. Franks Manufacturing reserves the right to determine dealership status at any time.