Deadlywind Paintball Barrels
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New Dealer Signup Form
Provide the information you have available. We will get back with you to confirm your dealer account request.
Account Name (for login)
Company Name
Description of Business
Date Business started
DBA Name (if used)
Primary Email Address
Primary Contact Name
Website URL
Receive Deadlywind Newsletter? (infrequent)
Primary Phone Number
Secondary Phone Number
Fax Number
Billing Address - line 1
Address - line 2
City
State
Zip
Country
Shipping Address - line 1 (leave blank if same as billing)
Address - line 2
City
State
Zip
Country
EIN/SSN Number
State Tax ID (for Texas only)
Which of our products do you wish to carry?
Business Structure (Corp, S-Corp, LLC, Sole Proprietor, Partnership, etc.
Type of Business- Distributor, Reseller, Store, Web, Field, Team
Number of Stores (if applicable)
Number of Fields (if applicable)
Store Square Feet
Field Acreage
Hours of Operation
How did you hear about us?
Accept Credit Cards?
Accept Paypal?
Accept UPS COD?
Have Online Store?
Have Physical Store?
Requested Credit Terms
Requested Credit Amount
DUNS Number
Accounts (AP) Payable Contact
AP Phone Number
AP Email
Authorized Purchaser(s)
2
3
Supplier Reference(s)
2
3
4
5
6
