Dealer/Reseller Application

Please complete the entire form so that we may fairly evaluate your request. If something does not apply, simply indicate N/A. Every application is reviewed to ensure that the Lightspeed brand will be represented in a manner consistent with our corporate objectives. The review normally takes seven to ten days.

COMPANY *

ADDRESS *

CITY *

STATE *

POSTAL CODE *

COUNTRY *

TAX ID NUMBER *

YEAR STARTED *

NUMBER OF EMPLOYEES *

DESCRIBE YOUR BUSINESS

Is your business located on an airport property? *
YesNo

AIRPORT CODE *

Are you aware of existing Lightspeed dealers near your business location? *
YesNo

Check the boxes that describe your primary business activities *
Pilot ShopFixed WingAvionics MxRotorcraftAirframe MxFlight SchoolAircraft SalesOther

IF OTHER, PLEASE SPECIFY

Identify the aviation brands for which your business is an authorized dealer.

HEADSET *

GPS *

HANDHELD RADIO *

INTERCOM *

AIRCRAFT *

WEBSITE *

OFFER WEB SALES? *

IF APPROVED, HOW MANY HEADSETS DO YOU EXPECT TO SELL IN THE NEXT 12 MONTHS? *

HOW DO YOU PROMOTE YOUR BUSINESS? *

CONTACT INFORMATION

PRIMARY CONTACT NAME *

TITLE *

EMAIL *

PHONE NUMBER *

FAX NUMBER