Dealer Application

Instructions

Please enter the following information about your dealership - and click the 'Submit Application' when you are done. International Users that can not use the phone and fax numbers as formatted for the United States - please include your phone and fax in the general comments area. The seperate State field is for international use only. Once your application has been reviewed - you will be contacted by phone or email. Please expect at least 7 days for us to review your application. Team Tekin

Store and Billing Information

Note - these fields are required *

Email Address:

Web Address:

Your Store Name:

Address 1:

Address 2:

City:

State:

or State: *

Country:

Zip/Postal Code:

Sales Exemption Number:

Phone:

( ) - Extension: *

Fax Number:

( ) - Extension:

Managers Name:

Account Payables Name:

Authorize Order Names:

Best time to contact:

Payment Method:

Visa MasterCard (online ordering) *

COD (Money Order or Company Check)

Store Shipping Information

Same

Enter alternate shipping address - or click the 'Same' checkmark box
on left If this address is the same as above.

Your Store Name:

Address 1:

Address 2:

City:

State:

or State: *

Country:

Zip/Postal Code:

Additional Store Information

Years in operation:

Years this location:

Annual Volume R/C $:

Projected Tekin Annual $:

Racetrack at facility:

yes no *

Carried Tekin in past:

yes no *

Tekin successful in past:

yes no *

Store Hours 1:

Store Hours 2:

Store Hours 3:

Trade References

Please enter 3 or more current r/c industry trade references

Company Name	Contact	Phone	eMail
*			*
*			*
*			*
*
*

General Comments

Comments:
1024 characters max

TEKIN
165 Commerce Street
McCall, ID 83638
(208) 634 5559

General questions - support@teamtekin.com