Motorcycle

Accessories
We appreciate your interest in Flanders Company. We feel we have the finest quality products and best shipping service avaliable. In order to protect you and our present dealers, we require certain information about your business to certify that the information below is correct.

Flanders Company does business with full time retail establishments in a commercial location. Others will pay suggested prices.

Please enclose a copy of your business license, resale certificate, photo of your store front, and a copy of your listing in the yellow pages.

Company Information

COMPANY NAME: 
PHONE:

ADDRESS:

CITY:   STATE: ZIP: -

STATE SALES TAX RESALE NUMBER:   FAX :

EMAIL ADDRESS:
                                   Valid email address is required to submit the form. Confirmation will be sent.

WEB SITE:

YEAR BUSINESS ESTABLISHED:   AT PRESENT SITE SINCE:

Officers, Partners or Owners: Home Addresses

TYPE OF OWNERSHIP:    CORPORATION    PARTNERSHIP    SOLE PROPRIETOR

NAME:  TITLE:   
PHONE:

ADDRESS:

CITY:   STATE:   ZIP: -

NAME:TITLE:   
PHONE:

ADDRESS:

CITY:   STATE:   ZIP: -

 

BANK NAME:   
PHONE:

CHECKING ACCT #

ADDRESS:

CITY:   STATE:   ZIP: -

 

BANK CONTACT PERSON:

 

Trade References: Please list three firms with whom you do business

 NAME:  ACCOUNT #

ADDRESS:

CITY:   STATE:   ZIP: -

NAME:  ACCOUNT #

ADDRESS:

CITY:   STATE:   ZIP: -

NAME:  ACCOUNT #

ADDRESS:

CITY:   STATE:   ZIP: -

Do above suppliers accept your company checks?   Yes    No

CITY OR COUNTY BUSINESS LICENSE:

Type of Business

  Franchised New Motorcycle Dealer       Used Motorcycle Dealer

Brands Carried:   

 Motorcycle Parts & Accessories Store     Motorcycle Repair Shop

Other Type of Business:  

Store Hours, and Days Open:  

Parts Manager:  

Is the business telephone number listed under the business name with the
telephone company?  Yes    No

If we call directory assistance and ask for your store by name, will they give us your
business phone number?  Yes    No

Is your business listed in the yellow pages?  Yes    No   
Under What Group Heading?  

Preferred Billing Method:   C.O.D.      Credit Card (Please provide CC information with first order).

Your Name:  Please Choose Password: (4-12 characters)

  Officer     Partner     Sole Proprietor    Other:  

Date:  

Comments:

I was referred to the Flanders Company web site by:  

             

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