Dealer/Distributor Application
Become a Collins Manufacturing and Collins Dollies Partner
Company Name *
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Company Website *
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Main Contact Name *
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Contact Email *
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Contact Phone Number *
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Bill-To Address *
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Ship-To Address (if different from Bill To)
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Company Registration Date *
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What Products/Services Do You Currently Offer?
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Which Country/State/Regions Do You Supply? *
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What Collins Products Are You Most Interested In? *
Expected Quarterly Sales *
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Do you already sell Collins or similar equipment? *
If "Yes" what are current volumes? *
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Trade References
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By entering your name below you agree that the information provided is accurate and you are the responsible person for this account. *
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