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AEM Dealer Application

Want to sell AEM Products? To start the process please download our dealer qualification form and fax it to us at 310-484-0152:

You may also start the process by filling in the application below.

NOTE - Fields indicated in bold are required for the form to be processed.

DEALERSHIP INQUIRIES FORM

Business Name:
First Name:
Last Name:
Position:
Address:
City:
State:
Zip:
Country:
Business Phone:		- -
Fax Number:		- -
website:
Email Address:
Business Type:		Retailer Jobber WD Tuner Installer Internet Sales/Mail Order Private Label Export Race Shop Specialist
Business Percentage Split Wholesale:
Retail:
Market Segment:		Sport Compact Domestic V8 Truck/SUV Powersports Motorsports Marine
Years in Business:
Size of Facility:
Dyno on Premises:
# of Employees:
Product Line Interest:		Engine Management System(EMS) Fuel Ignition Controller(F/IC) Engine Control Devices and Accessories Wiring Harnesses Gauges Water Injection Sensors Billet(Cam Gears & Fuel Delivery) All
Manufactures currently direct with:
If not direct who do you purchase product from currently:
Sales Volume (Current or Projected) Units:
Dollars: