* Name of Dealership:
Contact:
Address:
City: Province:Postal Code:
* Phone No.:
Fax No.:
* Email Address:
Website:
Please describe the location of your dealership:
(With specifics including area demographics and population)
Staff Information:
Number of Sales Staff:Number of Service Staff:
Number of Certified V-Twin Technicians:
Additional technician certifications (please list and describe):
Number of service bays:Service area square footage:
Dealership Information:
Current motorcycle authorized service center for: (e.g. Harley, Victory, Buell)
Current motorcycle authorized dealer for:
List the type of flooring your dealership has established: (Textron, G.E., Vintage, AFC or cash/bank)
List the square footage of the following:
Showroom:Apparel:Parts & Accessory Dept:
Please explain why your dealership would succeed as a Big Bear Chopers authorized dealer and why you want to represent Insane Customs Motorcycles:
By submitting this form, the authorized company officer, named below, represents that the information provided above is accurate and true as of this date, and we are able to rely on this information.
Name of Authorized Company Officer:
Title: