Dealer Signup Form

Instructions: Please make sure to fill out all required fields (fields marked with *), that no fields are red, that the passwords you enter match, and that you answer the User Validation question. If the Sign Up button is gray, please go back over the form to make sure everything looks right. Upon sucessful submission you should see a notice above the form that thanks you for your submission.

Primary Contact for Saffire Sales

*First Name:

*Last Name:

*Email:

*Phone Number:

You personal number for us to contact you.

*Country Calling Code:

Only required if you live outside the US.

Business Info for Dealer Locater

Country:

*Company Name:

*Street Address:

*City:

*State or County:

*Postal Code or ZIP:

*Email:

Phone Number:

Your business number for customers to use (if different than your contact phone number entered above).

Country Calling Code:

Only required if you live outside the US, and if your business uses a different country code than you entered above.

*Website:

Dealer Logo:

Dealership Info

Stock Method:

Saffire Display or Invoice Upload:

Saffire Dealers: Please attach a photo of your Saffire display. If you don't have a Saffire display, attach a copy of your last Saffire Grill invoice.
New Dealers: Please attach a photo of your current showroom/display area.

*Your Sales Representative:

I.e., representative's name, distributor's name, "Saffire Direct" or "NA".

Multiple Dealer Sites:
I own/control multiple dealer locations I want associated with my Dealer account

Account Credentials

*Username:

*Password:

*Password Again:

User Validation

*Please Enable JavaScript

Legal Agreement

*Agreement

I have read and agree to the terms of the Dealer Agreement.

There was a problem displaying the dealer agreement. Please contact us for assistance.