Dealer Application Form

Your Name *
Your Position at Your Company *
Please specify your position at your company*
Company Name *
Mailing Address *	City *
State *	Zip code *
Telephone *
Website *	Owner / Principles *
Primary Contact First Name*	Primary Contact Last Name*
Primary Contact Telephone *
Primary Contact Email *	Confirm Primary Contact Email *
Secondary Email	Confirm Secondary Email
How Did You Hear About Us? *
Please specify how you heard about us?*
"What projects does your company do?" Click All That Apply* Pool Spa General Home Improvements Select atleast one project
We can help you put the link on your website at no cost to your company (answering yes would mean we will request your website login credentials via e-mail)* Yes No
How many Client jobs/installs does your company sell a year? * Helps HFS know the programs for your customers and how many financing fliers/packets to send you.	Average Price of (1) job/install * Helps HFS know the right products for your customers.

By signing and submitting this form below I authorize you to contact me by phone and email of changes and updates. We do not sell or rent our dealer or customer contact information. For more information contact us at [email protected]
Digital Signature * (enter your name)	Date *