DEALER APPLICATION
pocket bike parts, pocket bike accessories, pbu, pocket bikes unlimited, 47cc pocket bike parts, 49cc pockety bike parts, pocket bike performance parts
COMPANY NAME: ________________________________________________

CONTACT NAME: ________________________________________________

CITY: __________________________________  STATE: _________  ZIP: ______________

TELEPHONE:  ________________________________  FAX: ______________________________

RESALE #  OR SELLERS PERMIT #  _________________________________

EMAIL ADDRESS:  _______________________________________________

WEBSITE (if available): ____________________________________________

HOW DID YOU HERE ABOUT PBU   (check one)      (  )  TRADE SHOW   (   )  WEB SEARCH  (  )  
FRIEND

(  )  BUSINESS ASSOCIATE    (  )  OTHER (please describe) ______________________________

ARE YOU CURRENTLY SELLING PERFORMANCE PARTS (circle one)   YES     NO    IF YES WHO
ARE

YOUR CURRENT SUPPLIERS (optional)  
________________________________________________

DO YOU SELL RETAIL  (  )  YES    (  )  NO

DO YOU HAVE A RETAIL SHOW ROOM  (  )  YES    (  )  NO

DO YOU PROVIDE SERVICE AND REPAIR  (  )  YES    (  )  NO

WHICH PRODUCTS ARE YOU MOST INTERESTED IN CARRYING _________________________

______________________________________________________________________________
(print clearly)
PLEASE COMPLETE THE ABOVE REQUESTED INFORMATION
AND FAX TO: 831-335-5229
www.pocketbikesunlimited.com
visit us at:
6281 Graham Hill Road
Felton, Ca. 95018
831-336-8218  fax 831-335-5229