Authorized Reseller Signup Form This is not an application form to become a direct dealer. This is an application to become an indirect, authorized reseller that purchases HP Tuners via distribution channels at a discount. Legal Company Name: * Purchaser or Owner Contact Name: * Address: * City: * US State/Can Province: * N/A AB AK AL AR AZ BC CA CO CT DE DC FL GA HI IA ID IL IN KS KY LA MA MB MD ME MI MN MO MS MT NB NC ND NE NH NJ NI NL NM NS NT NV NY OH OK ON OR PA PE PR QC RI SC SD SK TN TX UT VA VT WA WI WV WY YT Country: * Zip/Postal: * Business hours: Telephone Number: * Fax Number: Purchaser or Owner E-mail Address: * List any aliases or DBAs (if any) under which your business operates: * Select all the Distributors you are or will be purchasing our product from Hold CTRL or COMMAND to click on all that apply: Turn 14 PO orders Other Distributors (Separate with ";") Do you sell: Retail B2B Register your account Your Email * Your Password * Checking the box below indicates you have read and understand the HP Tuners Reseller Terms and Conditions. Unilateral Policy Submit Website: Please list any other tuning related manufacturer lines you sell: * Payment Types Accepted (Check all that apply): Debit American Express Discover MasterCard Visa PayPal All Of the Above Do you sell online using (Check all that apply): Walmart Amazon eBay Facebook NewEgg Bonanza Overstock Cdiscount Other online resellers or platforms you sell through:
