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Dealer application

Interested in becoming a Coaster retailer or Ecommerce dealer? Please fill out the form below and we’ll get back to you as quickly as possible.

I’m interested in becoming a Coaster dealer

Please select one *

Brick & Mortar Dealer

Brick & Mortar and Ecommerce Dealer

Contact information

Owner First Name *

Owner Last Name *

Email *

Fax

Phone *

Mobile Phone

Address *

Address Line 2

City *

State *

Zip Code *

Country *

Company information

Legal Business Name *

DBA (Doing Business As)

Company Website *

Sales Tax Certificate # *

Number of Stores

Average Size of Store(s) (sq. ft)

Type of Business

Type of Products Selling (please check all that apply)

Furniture

Mattresses

Electronics/Appliances

Other

If other please specify

If other please specify

Years in Business

Annual Sales Volume

Other Furniture Brands You Represent

Nearest Distribution Center *

Industry Memberships (please check all that apply)

BrandSource

HFA

FMG

Furniture First

Nationwide

TRIB

IAHSP

RESA

Other

If other please specify

Contact information

Owner First Name *

Owner Last Name *

Email *

Fax

Phone *

Mobile Phone

Address *

Address Line 2

City *

State *

Zip Code *

Country *

Company information

Legal Business Name *

DBA (Doing Business As)

Company Website *

Sales Tax Certificate # *

Number of Stores

Average Size of Store(s) (sq. ft)

Type of Business

Type of Products Selling (please check all that apply)

Furniture

Mattresses

Electronics/Appliances

Other

If other please specify

If other please specify

Years in Business

Annual Sales Volume

Other Furniture Brands You Represent

Nearest Distribution Center *

Industry Memberships (please check all that apply)

BrandSource

HFA

FMG

Furniture First

Nationwide

TRIB

IAHSP

RESA

Other

If other please specify

Company distribution channels

Online Marketplace(s) You Sell On (please check all that apply)

Amazon

Walmart

Jet.com

Ebay

Etsy

Google Shopping

Sears Marketplace

Overstock.com

NewEgg.com

Rakuten

Other

If other please specify

Other Ecommerce Sites You Sell On (i.e. non-marketplace(s))

Percentage of Business Through Ecommerce

%

Do you handle freight to consumers? *

Yes

No

Do you handle large item delivery via LTL? *

Yes

No

Do you handle small item delivery via Small Parcel Courier? *

Yes

No

Marketing Strategy

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