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Become a Dealer of Dazor Products

If you would like to become a dealer of Dazor products, please fill out the contact form below.

Legal Company Name *
DBA (if applicable)

Address *
Suite #

Address (line 2)

City *
State *
ZIP/Postal Code *

Primary Contact *
Title

Email Address *
Phone Number *

Website URL *

State Reseller Number *
Federal Tax ID Number *
Year Business Started *
No. of Employees *
Annual Sales *
Do you operate a showroom? *
Do you resell to others dealer? *

What other lighting or magnification products do you offer? *
Please list units sold per year for each product line

Describe your marketing strategy (print ads, direct mail, eblasts, etc.)? *

What geographic territories do you serve? *
What markets do you serve? *

Does your company attend tradeshows? *
If yes, which tradeshows do you regularly attend?

Is there anything else you would like to tell us about your business?

Current month ye@r (4 digits) day *

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Toll Free: 1-800-345-9103 | Phone: 314-652-2400 | Fax: 314-652-2069 | E-Mail