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Dealer Application

Primary Contact Information

First Name *

Last Name *

Email Address *

Use the same email address for Owner and Purchaser

Company Profile Information

Business Name *

Billing Address *

ZIP *

Country *

State/Province/Region

(optional)

City *

Shipping Address *

Shipping address is the same as Billing address

ZIP *

Country *

State/Province/Region

(optional)

City *

Contact Name *

Business Phone *

Business Fax

Website(s)

(Please enter comma separated urls like "http://www.site1.com, http://www.site2.com, https://www.site3.com/home")

Date Business Started *

(Please enter date like "08/21/1997" or "11/02/2007"

How long at present address

Business License or state resale cert. # (Please attach copies) *

Select File(s)

Allowable file types (jpg, jpeg, png, txt, pdf, doc, docx). Max upload file size is 1 MB.

CA Resale Certificate (Please attach copies) *

Select File(s)

Allowable file types (jpg, jpeg, png, txt, pdf, doc, docx). Max upload file size is 1 MB.

How did you hear about us? *

Do you attend trade shows? If so, which ones? *

Please, specify *

Do you sell to the retail public? *

YesNo

If no, please explain how you plan to sell our products? *

Do you have a store front? *

YesNo

How many square feet is your store? *

Please provide a photo of your store *

Select File

Allowable file types (jpg, jpeg, png). Max upload file size is 1 MB.

File Name

How many stores do you have? *

STREET ADDRESS (If different from above)?

How do you classify your business? (check all that apply) *

What is your market focus? (Biker, Sporting Goods, Military, Law Enforcement, Contracts/Bids, etc.) *

List other brands you currently carry? *

(Please provide comma separated brand names)

What is your estimated forecast for our products? *

Year 1 *

Year 2 *

Please list all other countries you sell to: *

Country *

Are you a dealer located within the United States?

YesNo

Are you a dealer located in a country outside the United States?

YesNo

Are you a distributor located within the United States?

YesNo

Are you a distributor located outside the United States?

YesNo

Select preferred payment type *

C.O.D.Credit Card

FOR INTERNATIONAL DEALERS THE ONLY METHOD OF PAYMENT ACCEPTED IS WIRE TRANSFER

Duns# *

Tax ID# *

How many sales reps do you currently have? *

In House *

On the Road *

How many dealers do you currently sell to? *

How many warehouses do you have? *

What territory are you going to be covering? *

Do you participate in bids/tenders?

YesNo

what percentage of your business is from bids/tenders?

Are CE certifications important to your customers? *

YesNo

I agree not to make wholesale prices available to the public: *

If you are applying to become a distributor and wish to sell products online, wholesale prices must be password protected; the products may not be searchable via any internet search engine where wholesale prices are shown.

YesNo

Do you produce and mail a catalog for consumers to purchase from? *

YesNo

If you print a catalog, how many versions do you print on an annual basis? *

How many catalogs do you send out annually (total)? *

How many pages on average are your catalogs? *

Please Upload Image of Front of Catalog *

Select File

Allowable file types (jpg, jpeg, png). Max upload file size is 1 MB.

File Name

I expressly agree that Balboa has the option to proof any printed material that includes Balboa product before being sent to consumers

YesNo

Do you intend to sell Balboa products online? *

YesNo

Products to be sold online (Check all that apply): *

BobsterZanheadgear

Types of products sold online: *

Please Provide ALL URLs where items will be posted and all other URLs managed by your company: *

Do you sell on any auction or discount websites? (i.e. eBay or Amazon) *

YesNo

If yes, please provide your username and/or business name you sell under on these sites, plus the URL *

Amazon

(Please enter url like "http://www.site1.com" or "www.site2.com")

Amazon Username

% of your total sales from Amazon:

# on Amazon:

EBay

(Please enter url like "http://www.site1.com" or "www.site2.com")

EBay Username

% of your total sales from eBay:

# of SKUs to be listed on eBay:

Other

(Please enter url like "http://www.site1.com" or "www.site2.com")

Other Username

% from other:

# from other:

I have read and understand Balboa's internet dealer policy (Link Provided):

YesNo

Products of interest: (Please check all the apply)

Vice President/Owner *

Phone

Email

Purchaser

Phone

Email

Terms and Conditions

Possession of a price list, and/or submission of application, does not constitute an offer to sell. We reserve the right to refuse any orders. Product specifications are subject to improvement or change without notice. Orders are accepted at price prevailing at time of shipment. Prices are subject to change without notice.

ACCOUNTS: All orders COD or credit card (Visa, MasterCard, AMEX or Discover) in U.S. funds. Net 30 or COD with credit approval for US customers only. International customers must pay in US funds via T/T. Past due accounts subject to interest penalty of 1.5% per month (18% per year). Returned check fee is $30.00. Collection and legal fees added to overdue accounts. Policy is strictly enforced.

SHIPPING: All orders FOB Seller’s Warehouse in San Diego, CA USA. Standard shipping is via UPS Ground (unless otherwise specified). Shipping, handling, insurance and COD charges will be added to order. Delivery to carrier constitutes delivery to purchaser. Claims for merchandise damaged or missing in transit must be filed immediately with the carrier.

All returns must be pre-authorized by Balboa Manufacturing; a re-stocking fee of 15% will apply to all returns. Returns will not be accepted after 90 days from invoice date. Return shipments must be freight pre-paid. Refused shipments will incur a 10% restocking fee in addition to freight charges. Returned items must be returned in original condition.

WARRANTY: All products manufactured by BMC, are warranted to be free from defects in materials and workmanship. Product warranty does NOT apply to normal wear and tear or product damaged or destroyed through abuse or goods or product soiled through no fault of BMC. Merchandise returned for warranty will be repaired or replaced with new or reconditioned parts at our discretion. Discontinued items will be repaired if replacement parts are available or replaced with an item similar to original purchase.

INTERNET DEALERS/CUSTOMERS: ACCOUNTS MUST RECEIVE PRIOR WRITTEN NOTIFICATION TO SELL OR PROMOTE ANY BALBOA MANUFACTURING PRODUCTS ON THE INTERNET. CUSTOMERS MAY ONLY SELL BMC PRODUCTS ON THE WEBSITES/URLS THAT HAVE BEEN APPROVED. WEBSITE(S) MUST BE REVIEWED AND APPROVED BY BMC MANAGEMENT TO ENSURE ACCURATE INFORMATION. CUSTOMERS IN VIOLATION OF THIS AGREEMENT MAY BE DROPPED FROM BMC’S DISTRIBUTION NETWORK INDEFINITELY. PROSPECTIVE CUSTOMERS WHO ONLY SELL BALBOA PRODUCTS ON WEBSITES AT ONLINE AUCTIONS, EBAY STORES AND BARGAIN/DISCOUNT WEBSITES MAY NOT RECEIVE VOLUME DISCOUNTS AND MAY BE SUBJECT TO A 10% PREMIUM CHARGE REGARDLESS OF WHETHER CUSTOMER HAS A WEBSITE THAT SELLS OTHER PRODUCTS.

I HAVE READ AND UNDERSTAND BALBOA’S TRADEMARK USAGE GUIDELINES (Link Provided) * :

YesNo

BY SIGNING BELOW, I CERTIFY THAT ALL OF THE INFORMATION SUPPLIED IS TRUE AND THAT I HAVE READ AND UNDERSTAND ALL POLICIES ASSOCIATED WITH BECOMING AN AUTHORIZED DEALER OR DISTRIBUTOR OF BALBOA MANUFACTURING PRODUCTS. I UNDERSTAND THAT FAILURE TO ADHERE TO THESE POLICIES MAY RESULT IN IMMEDIATE SUSPENSION FROM BALBOA MANUFACTURING’S DISTRIBUTION NETWORK. I UNDERSTAND THAT BALBOA HAS THE RIGHT TO REFUSE THE SALE OF GOODS TO ANY CUSTOMER AND THAT SUBMISSION OF THIS APPLICATION DOES NOT CREATE AN OBLIGATION OF EITHER PARTY TO ENTER INTO A BUSINESS RELATIONSHIP.

AUTHORIZED SIGNATURE (Must be an officer or owner) *

Review your signature

Draw your signature

Draw It
Clear

PRINTED NAME

Title

Date

(Please enter date like "08/21/1997" or "11/02/2007"

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Wholesale Catalog Request

To request our wholesale catalog, please fill out and submit the form below.

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Select which catalog/s you are requesting *

ZANheadgear^®
Bobster^®
Tactical - Available by PDF only
Winter Supplemental

Are you an existing Balboa Manufacturing customer? *

YesNo

Account Number (if you are an existing customer)

First Name *

Last Name *

Email Address *

We need your email address to contact you about your order.

Company *

Street address *

Country *

State/Province/Region

(optional)

City *

Zip/Postal Code *

Telephone (enter as XXX-XXX-XXXX) *

How did you find us?

Please select the category that best applies to your organization

What format would you like in your catalog in? *

US Mail - Printed Catalog
Email - PDF (Earth Friendly)
Both PDF and Printed Catalog

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