Dealer Application

Attention: We do not deliver to California, Alaska, or Hawaii at this time.

Applications are reviewed for approval within 3-5 business days of submission.

First Name:
Field is required!
Last Name:
Field is required!
Date:
Field is required!
Phone Number:
Field is required!
EIN:
Field is required!
Business Name:
Field is required!
Business Street Address:
Field is required!
City
Field is required!
Zipcode:
Field is required!
State
  • - select a state -
  • Alabama
  • Arizona
  • Arkansas
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Field is required!
Do you have a shop/storefront?
  • - select a option -
  • Yes
  • No
Field is required!
Do you want your address added to our Dealer Locator?
  • - select a option -
  • Yes
  • No
Field is required!
Email:
Field is required!
How long have you been in business?
Field is required!
Website:
Field is required!
Have you tried our products?
  • - select a option -
  • Yes
  • No
Field is required!
What market do you specialize in?
Field is required!
Have you heard of Stealth?
  • - select a option -
  • Yes
  • No
Field is required!
What social media platforms are you active on?
Field is required!
How would you market Stealth?
Field is required!
Username:
Field is required!
Password:
Please make sure your password is at least 8 characters long.