Confidential Dealer Application
By completing this form, you are applying for Dealer status with Transland. All information will be held in strict confidence.
Please complete the information below for the primary business location. If your business has multiple locations or branches, that information will be collected at a later time.
Your Shipping/Location address should be where parts orders are received. Additionally, this address will be utilized on our website dealer location listing, so should be where customers will find you to do business.
If you utilize a PO Box or have a separate mailing address for business coorespondance, please list that information here.
Please supply the contact information for these two key areas where our personnel would have the most significant interaction.
Transland utilizes electronic invoicing. This e-mail address should be where Invoices can be received. Please use a generic address (i.e. Accounting@TranslandLLC.com) if applicable.
Please use a generic address (i.e. Sales@TranslandLLC.com) if applicable.
(Select each product line you are applying for)
If you have a pre-printed page of Credit References, please attach here and skip to the Authorization section below.
By filling in my complete name, I hereby authorize Transland to contact the references supplied pertaining to our credit and financial responsibility. All information included in this form or communicated by references will be regarded as confidential information.