Business Name *

First Name *

Last Name *

Email Address *

Business Phone *

Business - Country *

Business Address *

Sales Channels *

Storefront
Website
Social Media
Events
Other

Website URL

HST, EIN, Business License Number * *

Expected Annual Unit Volume *

10 100

Additional Details *

Terms & Conditions:

Submission of this form does not guarantee acceptance or recognition as a Lectron Certified Dealer. All applications are subject to review and approval by Lectron. Only registered businesses with valid credentials will be considered. Incomplete or fraudulent submissions will be disregarded. By submitting this application, you agree to be contacted by Lectron regarding your dealer status and understand that certification is not granted until formally approved in writing.

I agree Terms and Conditions *

Thanks for your application to become a Lectron dealer!

We appreciate your application. One of our colleagues will review your application and reach out to you shortly!

Have a great day!

Thanks for your application to become a Lectron dealer!

We appreciate your application. One of our colleagues will review your application and reach out to you shortly!

Have a great day!

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