Leave this empty

Your business

Legal business name

Store name (if different)Website or social media page (optional)

Street addressSuite, unit (optional)

CityProvince / territoryChoose…AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonPostal code

GST/HST number

Contact person

NameTitle (optional)EmailPhone

Stores and sales channels

Do you have a physical retail store?

YesNo

Sales channels (choose all that apply)

Online store on your websiteAmazoneBayOther online marketplaceFacebook / Instagram / social mediaMarine installation / service

Will you resell Accuphy products to other dealers?

YesNo

Experience

Do you sell marine electronics today?

YesNo

Your main customers (optional)

FreshwaterSaltwaterIce fishingBass / tournamentGeneral marineOther

Do you have Pro-Staff?

YesNo

Your plan

Expected first order (units, minimum 5)

5–910–2425–4950+

Will you sell across all of Canada?

YesNo

I confirm this is accurate. Applying doesn't make me an authorized dealer.Email me Accuphy news and dealer updates. Unsubscribe anytime.Submit application