Dealer Application

We appreciate your interest in becoming a dealer with Hill Marine.Com Inc.. We feel we have fine
quality products at a very competitive price. In order to protect you and our present dealers, we
require certain information about your business to certify that the information below is correct.

With your application you will be required to provide the following pieces of information.

*Business License
*Copy of resale certificate
*Copy of current or previous advertisement
Please fill out the below information
Your Name:
Company Name:
Web Address:
Email Address:
Telephone Number
Physical Address
Years of Business
Main Business
Resale Number:
Type of Business
Please type the names of three business you are
currently doing business with.