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Dealer Application

Contact Information
Company Information
Contractor & Business Details

Your Information

Enter your first name
Enter your last name
Enter your job title
Enter the best number to reach you in case we have any issues with your dealer application. Please enter your phone number in a US format. E.g: 212-999-9999
Enter your email address
Verify the email address
If you've been in contact with a Soligent sales rep, please provide their name

Company Information

Enter your company legal name
Enter your company DBA, if applicable
Enter your business phone in a US format. E.g: 212-999-9999
Enter your business fax in a US format. E.g: 212-999-9999

Business Billing Address

Enter your street address, P.O. box
Please enter your suite, unit, building, floor, if applicable
Enter your city
Select your state
Enter your zip or postal code
Select your country

Contractor License Details

Select your license state
Enter your contractor license type
Enter your resale certificate number, if applicable

Business Details

Enter your company website
Select your business's entity type

Accounts Payable

Your Information

Billing Address