Become a Golden Dealer for Lift Chairs Scooters Powerchairs Power Wheelchairs

Name*

First Last

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Company Name*

Company Website

Do you want to be a "service only" dealer?*

Will you only offer service of Golden Products as an authorized service center?

Do you have a showroom?*

Has your company done business with Golden in the past?*

Are you a furniture store?*

Are you exclusively online internet dealer? (No physical storefront)*

Do you need to sell products online with dropship?*

Only answer YES if this is a requirement or your application could be denied automatically.

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