Dealer Application

Take the first step toward becoming an authorized Royalty Core dealer. Fill out this brief form and we'll have a representative contact you within 48 hours.

Contact Information

First Name *

Last Name *

Address Line 1 *

Address Line 2

City *

State

Zip / Postal Code *

Country

Email *

Website Address

Phone # *

Dealer Information

Company Name

Type of Business *

Years in Operation *

Number of Employees *

Owner(s) *

Business License # or EIN *

Resale *

Sales Information

Estimated Units/Month *

Sales Channel(s) *

Retail Location

Catalog

Internet

Royalty Core Products Needed Now (list part numbers) *

Industry References

For each reference, please provide a name, contact information, a brief description of your business relationship, and any other relevant information you would like us to consider in evaluating your application.

Reference 1

Reference 2

Reference 3

Additional Information

Preferred Response *

Questions or Comments *