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!
Field is required!
Last Name:
Field is required!
Field is required!
Date:
Field is required!
Field is required!
Phone Number:
Field is required!
Field is required!
EIN:
Field is required!
Field is required!
Business Name:
Field is required!
Field is required!
Business Street Address:
Field is required!
Field is required!
City
Field is required!
Field is required!
Zipcode:
Field is required!
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!
Field is required!
Do you have a shop/storefront?
  • - select a option -
  • Yes
  • No
Field is required!
Field is required!
Do you want your address added to our Dealer Locator?
  • - select a option -
  • Yes
  • No
Field is required!
Field is required!
Email:
Field is required!
Field is required!
How long have you been in business?
Field is required!
Field is required!
Website:
Field is required!
Field is required!
Have you tried our products?
  • - select a option -
  • Yes
  • No
Field is required!
Field is required!
What market do you specialize in?
Field is required!
Field is required!
Have you heard of Stealth?
  • - select a option -
  • Yes
  • No
Field is required!
Field is required!
What social media platforms are you active on?
Field is required!
Field is required!
How would you market Stealth?
Field is required!
Field is required!
Username:
Field is required!
Field is required!
Password:
Please make sure your password is at least 8 characters long.
Please make sure your password is at least 8 characters long.
Submit