Dealer Application

Thank-you for the interest you have shown in acquiring a Preston Cycle Products Inc. dealer account. As a distributor of aftermarket parts and accessories for Harley motorcycles we do not sell to the general public. To obtain dealer status with Preston Cycle we require you to complete and submit a dealer application along with supporting material and place a minimum initial order of $500.00. All orders are shipped prepaid by Visa or Mastercard.

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Company Name *
Address *		City *
Province *	Post Code *	Country *
Phone *	Fax	Email *
Website
Business Type Corporation Partnership Sole Proprietorship		Established Date

Owners, Partners, Shareholders
1.	Full Name *	Address *	City *	Province *	PC *	Phone *
2.
3.
4.

Type of Franchise
Franchise Dealer (state make)	Franchise No
Accesory Shop Repair Shop Used Bikes

Financial Information
Bank Name *
Have you had any NSF cheques in the past?

1. Business References (Mandatory)
Company Name *
Address *		Customer No.: *
Prov/State: *	Country: *	Postal Code *
Tel. *	Fax	E-mail

2. Business References (Optional)
Company Name
Address		Customer No.:
Prov/State:	Country:	Postal Code
Tel.	Fax	E-mail

3. Business References (Optional)
Company Name
Address		Customer No.:
Prov/State:	Country	Postal Code
Tel.	Fax	E-mail

Verification Code

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Hard Parts Specialist for Harley-Davidson® Motorcycles