Stright-MacKay - Become a Dealer

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	FIND A DEALER

	BECOME A DEALER

Stright-MacKay Dealers enjoy special pricing, great deals on shipping and preferred customer service. If you'd like to benefit from the Stright-MacKay advantage, please fill out the form below. A Stright-MacKay representative will contact you shortly.


Fields with asterisks (*) are required
Company Name *	This is a required field. Please enter your company name.
MAILING
Address Line 1 *	This is a required field. Please enter your company's address.
Address Line 2
City *
Province/State *
Postal Code/Zip *
SHIPPING
Address Line 1 *
Address Line 2
City *
Province/State *
Postal Code/Zip *
CONTACT
Phone *
Fax
Email *
Website

Business number or Federal tax ID number *
Type of business *
Date business established *
Purchasing contact *
Accounts payable contact *
Are you a: *	Corporation Partnership Individual
NAMES, TITLES, AND ADDRESSES OF PRINCIPLES
Name *
Title *
Address Line *
City *
Province/State *
Postal Code/Zip *
PRINCIPLE #2
Name
Title
Address Line
City
Province/State
Postal Code/Zip
PRINCIPLE #3
Name
Title
Address Line
City
Province/State
Postal Code/Zip
NAMES, ADDRESSES, PHONE AND FAX OF TRADE REFERENCES
REFERENCE #1
Name *
Address Line *
City *
Province/State *
Postal Code/Zip *
Phone *
Fax
REFERENCE #2
Name
Address Line
City
Province/State
Postal Code/Zip
Phone
Fax
REFERENCE #3
Name
Address Line
City
Province/State
Postal Code/Zip
Phone
Fax
Purchase order required? *	Yes No
Faxed invoices acceptable? *	Yes No
Faxed monthly statements acceptable? *	Yes No
Unless otherwise specified above, invoices and monthly statements will be faxed and not mailed.
Application Submitted by:
Name *
Title *