Become an Authorized Dealer Become an Authorized Dealer Become an Authorized Dealer Company Name * Company Billing Address * Company Billing City * Company Billing State * Company Billing Zip * Shipping Check Shipping address same as billing address Company Shipping Address * Company Shipping City * Company Shipping State * Company Shipping Zip * Company Phone * Company Fax * Company Website * Company Contact Name * Company Contact Title * Company Contact Email * Company Contact Phone * Owner Check I am the owner of this business Company Owner Name (if different from Company Contact) * Company Owner Email * Company Owner Phone * How did you hear about us and what brings you to our products? * Can you provide images of your store? * Yes No Do you have a storefront? Multiple locations? (Please provide 2-3 photos of your storefront & retail floor) Drop a file here or click to upload Choose File Maximum file size: 2.1MB Maximum file upload size: 3MB Drop a file here or click to upload Choose File Maximum file size: 2.1MB Maximum file upload size: 3MB Drop a file here or click to upload Choose File Maximum file size: 2.1MB Maximum file upload size: 3MB Do you sell online? * Yes No Do you have a resale certificate in the state in which your business is located? * Yes No What types of products do you currently sell? * Which types of Iwata, Artool, Createx and/or Medea products are you interested in stocking in your store? * What types of customers will you be primarily marketing to? * Do you host classes at your store(s)? * Yes No Submit
