Dealer Application

Please fax this form to: Little Guy Dealers at (330) 494-5149

Personal Information

Name: _______________________________________

Address: : _______________________________________

                _______________________________________

City: _______________________________________ State: ______________ ZipCode: _____________

Business Information

Do you have an existing business?   � Yes   � No

Type of business: ___________________________________________________

Number of years in business ________________________

Annual Sales:

� Under $100K
� $100K-$500K
� $500K - $1M
� $1M - $5M
� Over $5M

Business Name: _____________________________________________________

Type of Business: � Corporation   � LLC  � Partnership  � Sole Proprietor

DBA: ___________________________________________

If proprietorship, Estimated Net Worth:

� Under $100K
� $100K-$500K
� $500K - $1M
� $1M - $5M
� Over $5M

Business Address: ___________________________________________________

                             ___________________________________________________

City: _______________________________________ State: ______________ ZipCode: _____________

Contact Information

Daytime Phone: _____________________________

Cellular Phone: ______________________________

Best time to call: __________________

EMail: _______________________________________

References

Business

Name: _____________________________________________

Company: __________________________________________

Phone: _____________________________________________

Bank

Bank Name: _________________________________________

Address: ____________________________________________

Phone: ______________________________________________

Contact Name: ________________________________________

Other Information

How did you find out about Little Guy Teardrop Trailers?

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Comments:

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