AV Dealer Sign Up Form

Dealer Registration

If you are interested in becoming an EpiXsky dealer, please fill out the registration form below.

Company Name DBA *

Attn / Title

Phone

Website / URL

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

*Shipping Instructions

Type of Ownership

Corporation, Partnership, LLC, LP, Other?

Date Established

Years in business?

SIC Code #

Federal ID #

Resale Tax #

Add Authorized buyers here

How many employees do you have?

How many are sales, how many are installers?

Average equipment billing per job?

What was your total company revenue last year?

Who will be performing the system programming?

Interested in the epiXsky training program?

How do you see epiXsky fitting into your product mix?

How many jobs do you average per year?

Percent of your jobs are new construction?

What percent of your jobs are retro-fit?

What percent of your jobs are commercial?

What is your projection for revenue this year?

What other companies are you associated with?