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?* Do you currently carry liability insurance?* Yes No Do you have the ability to get an electrical permit if this is required in your area?* Yes No Are 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 name Please tell us a little about you, your existing business and your vision for Gemstone Lights products in your area*Website URL Facebook Page URL Twitter URL Instagram URL How did you hear about us? Facebook Google YouTube Instagram Sign Trade Show International Builder Show Flyer Family Friend Email Website Radio Other Check all that applyDescribe Other
