New Dealer Account Application Form

PRINT This Page (1) and Page 2. Fill them out. Sign, and fax to 905 564-4956!!
  AURORA OFFROAD
Div. of Aurora Marine Industries
 

7015 Ordan Drive, #11,  Mississauga, Ontario, Canada, L5T 1Y2
Tel: (905) 564-4995 Email: dealerinquiries@auroraoffroad.com
Fax: (905) 564-4956 www.auroraoffroad.com

NEW DEALER APPLICATION FORM Page 1 of 2

Trade Name:
______________________________________________
Date:
_____________________________

Corporate Name:
______________________________________________
Phone:
_____________________________

Mailing Address:
______________________________________________
Fax:
_____________________________

Shipping Address:
______________________________________________
Email:
_____________________________
   
Website:		 _____________________________

City:  _______________________   State/Province:  ____________________      Zip/Postal Code:  _____________________

Shipping instructions: _____________________________________________________________________________________


Please check one of the following:  

IF CORPORATION: ...........................

IF SOLE PROPRIETORSHIP: ...........

IF PARTNERSHIP: ............................


Corporation: [ ]       

President's Name:

Principal's Name:

1) Partner's Name:

2) Partner's Name:


Proprietorship: [ ]       Partnership: [ ]

_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

Responsible Financial Person ....................................... :
_______________________________________________________

Length of time in Business under this name:  Since: _______________ Years: ________________ Months: _______________

Federal ID # or PST#: ___________________ State Tax # or GST #: ____________________ Limit Requested: $___________

Is Purchase Order Requested? Yes [ ] No [ ]      Type of Account Requested: Open [ ]      Charge: Visa [ ] Mastercard [ ]

Type of Dealership: SkiDoo: [ ]     Polaris: [ ]     Artic Cat: [ ]     Yamaha: [ ]     Other ___________________________________

Business Premises: Owned: [ ]       Rented: [ ]       Length of Lease: _________________________________________________

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