Fluent Forms Template Library

Dealer Application Form Template

Onboard new resellers with this dealer application form

Dealer Application Form

Dealer Application Form
  • Business Info
  • Primary Contact
  • Business Profile
  • References & Documents
  • Agreement

About this template...

This dealer application form is for manufacturers, wholesalers, and distributors building a dealer or reseller network. It replaces back-and-forth emails and paper applications with one structured submission. You have everything you need to review and approve a new dealer in one place.

Applicants begin with their legal business name, trade name, business type, years in business, tax ID, address, phone, and website. They then add a primary contact person with job title, email, and direct phone number.

Next comes the business profile: sales channels, number of locations, annual revenue, product lines of interest, proposed territory, brands already carried, and expected monthly order volume. Applicants list trade references, upload a business license or resale certificate, and sign to confirm the information and authorize verification.

Dealer Application Form

Features of this Template

  • Complete business and tax details for faster vetting
  • Sales channel, territory, and revenue questions to assess dealer fit
  • Product line selection so applicants can choose several at once
  • Trade references that applicants can add as needed
  • License or resale certificate upload with a signed agreement
  • Easy to customize product lines, territories, and dealer terms