Dealer Application

We must receive all of the following items from your company to become a dealer with Curly's Inc.

Please complete Dealership Application (form below) AND then email all of the following to office@curlysinc.com :

Copy of your current business license / retail tax certificate
ST-105 Form
Photo of your store front, sign and interior of shop

Company Name*
Owner's Name*
First Last
Address*
Street Address City State ZIP Code
Phone*
Email*
Website
Years in Business
Tax Permit # (no dashes or symbols)*
Business License # (no dashes or symbols)
Upload Business Documents
Drop files here or

Max. file size: 3 MB.
Photo of your store front, sign and interior of shop
Drop files here or

Max. file size: 3 MB.
Consent*
I agree to the privacy policy.
Indemnity: Buyer shall indemnify and defend Curly’s Inc. and its affiliates against any and all losses, damages, and expenses (including attorney’s fees and other costs of defending any action) that it may sustain or incur as a result of (I) The use, operation or possession of the products by the buyer, (II) The alteration or modification of the products or the use or combination of the products with other products or devices by the buyer, (III) A negligent or willful act or omission of the buyer, (IV) The breach by buyer of this contract, or (V) The failure of the buyer to comply with any applicable law or regulation. The buyer agrees to not copy or duplicate Curly's Inc manufactured parts.

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Curly's Cycles Contact Form