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
