Become a Dealer — MicroPDM

Dealer Application

Complete this form to begin our dealer review process. A MicroPDM representative will review your application and contact you within 1-2 business days.

Company Name

DBA / FBN

Business alias, such as a Doing Business As (DBA) or Fictitious Business Name (FBN)

Contact Name

First Name

Last Name

Business Owner

First Name

Last Name

Business Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Website

http://

Tax ID

Type of Business

Partnership

Corporation

Sole Proprietor

LLC

Years in Business

Type of Dealer

Shop / Installer / Car Builder

Product Supplier / Developer

Product Distributor

Product Retailer

Questions or Comments