Century Helicopter Products Logo

Manufacturing and Marketing R/C helicopters since 1987

 > Dealer Application Form

Online Dealer Application Form


Dealer Application Form (Secured Form)

Fill out the fields as accurately as you can. All fields in bold are required. Any inaccuracy or missing required field may delay the approval of your application.
 
Store Information
Business Name:
Corporate Name:
Street Address:
City:
State/Province:
Zip:
Country:
Purchasing Contact:
Business Phone: Business Fax:
Owner Information
Owner Name:
Address:
Phone:
Co-Owner Name:
Address:
Phone:
Business Demographics
Do you carry
Helicopters:
Yes:    No: Years in
Business:
Number of full time
employees:
Number of part
time employees:
Website:
E-mail:
Business License:
Sales Tax:
Annual Sales Volume:
Bank Information
Bank Name:
Branch Name:
Street Address:
City:
State/Province:
Zip:
Country:
Contact person
at branch:
Business Phone: Business Fax:
Business Checking
Account:
Trade References
Company Name: Company Name:
Address: Address:
Phone: Phone:
Company Name: Company Name:
Address: Address:
Phone: Phone:
Preferred Pricing
*
* Dealer pricing requires that the 1st three purchases be paid via COD-CASH or with a Credit Card.
   International dealers are required to pay via wire-transfer.
* Distributor pricing requires that the first order be at least $10,000.00 USD.
Release of Confidential Information

I hereby acknowledge that the information I have provided is correct and that any merchandise purchased from Century Helicopter Products is for resale only.

I understand that after commencing into a business relationship with Century Helicopter Products and credit has been granted, the sole discretion of Century Helicopter Products to extend, continue or terminate credit at any time.

I authorize Century Helicopter Products to make any credit inquiries that it deems necessary in addition to the credit application for review of my company's total financial standing.

I authorize any person or credit reporting agency to release to Century Helicopter Product any information it has or obtain to verify credit standing, and along with this application, this information will remain the property of Century Helicopter Products.

I understand that I will, from time to time, receive e-mails relating to Century Helicopter Products and it's products.
 
Company Name:
Owner:
Position: