Become a Kestrel Dealer

 

Kestrel® Dealer Account Application

A completed application must be on file prior to ordering at wholesale pricing.

ALL ITEMS ARE REQUIRED.

Company Name:

Please enter your company's name.
Billing Address:
Please enter the billing address.
Shipping Address:
Please enter the shipping address.
Phone:
Please enter your phone number.
Fax:
Please enter your fax number.
Website: (http://www.mysite.com)
Please enter your website URL.Invalid format.
Accounts Payable Contact:
Name: Please enter the name of the Accounts Payable contact.

Phone: Please enter the phone number of the Accounts Payable contact.

Email: Please an email address for the Accounts Payable contact.Invalid format.
Purchasing Contact:
Name: Please enter the name of the Purchasing contact.

Phone: Please enter the phone number of the Purchasing contact.

Email: Please enter an email address for the Purchasing contact.Invalid format.
Email Address for Shipment Notification:
Please enter an email address to receive shipment notifications.Invalid format.
Email Address for Special Promotions:
Please enter an email address to receive special promotions.Invalid format.
Resale License/Permit, Sellers Tax Permit or Use and Sales Tax License/Permit:
State: Please enter your license or permit state.

Number: Please enter your license or permit number.

Federal Tax ID Number:
Please enter your Federal Tax ID number.

Please fax or send a copy of your license to: 21 Creek Circle, Boothwyn, PA  19061 USA.

24-hr fax line: 610.447.1577

Sales Methods:


          
(Mailed:  times per year; Approx. circulation: )

Countries sold to:
Please specify the countries you sell to.
Markets (Outdoors, Hunting, HVAC, Military, etc.)
Please specify the markets you sell to.
Where you learned about Kestrel products:
Please let us know where you learned about Kestrel products.
How do you plan to pay for your purchases?
I will pay by Credit Card (VISA/MasterCard)
I will pay in advance by wire transfer
I will require a written quotation to issue payment
I wish to establish a Net-30 Account with Nielsen-Kellerman (please complete Credit Application)