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B2B
Dealer Application
Company Name
Address 1
Address 2
City
State
Zip
Phone
Fax
Email
Web Site
Main Contact
Title
Years in Business
Federal ID Number
Number of Employees
What products are you interested in?
Ex Mustang, Import, Domestics, trucks, etc.
What clutches are you currently selling?
What clutches are you currently stocking?
Why are you interested in
selling CCI products?
Primary nature of your business
Auto Repair
Warehouse Distributor
Jobber
Individual
Retail Only
Do you sell retail? (Y/N)
Do you sell online? (Y/N)
Do you have installation capabilities? (Y/N)
If so, how many bays do you have?
If you have any questions or concerns about this application, please contact us at 1-800-809-6598 or
dealers@competitionclutch.com