GEMSTONE LIGHTS Dealer Application Name* First Last Email* Phone*Company Name*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country *CanadaUnited States Country What type of business do you run?*(Lighting company, electrical service, landscaping, Christmas decor, etc..)How long have you been running your business?*What geographical areas do you currently operate your business?*How many employees are on staff?*2-55-1010-2525-5050+Do you currently carry liability insurance?*YesNoDo you have the ability to get an electrical permit if this is required in your area?*YesNoAre you currently selling any other lighting products?*Yes/ No? If yes, please list what productsDo you currently have a business relationship with an existing Gemstone Lights Dealer?*YesNoIf yes, please provide the Dealers namePlease tell us a little about you, your existing business and your vision for Gemstone Lights products in your area*Website URLFacebook Page URLTwitter URLInstagram URLCAPTCHA
