Seakeeper Dealer Application

Company Name
First Name *
Last Name *
Email Address *
Phone Number *
Web Address*
Total Employees*
Annual Revenue*
Number of Physical Locations*
City/State/Country of Each Location*
Mobile Support Capabilities*
Technical Expertise (i.e. fiberglass, electrical, mechanical, welding, engineering, etc.)*
Other Brands You Service or Represent*
Number of Technicians Employed*
Standard Labor Rate/Hour*
Warranty Labor Rate/Hour*
Travel Labor Rate/Hour*
Mileage Reimbursement Rate*
Why do you want to become a part of Seakeeper’s global support network?*
Are there any additional details you’d like us to know about your business?
What type of Seakeeper services would you like to offer?
Select all that apply.
Attach Current Form W-9
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Dealer Application