GEMSTONE LIGHTS
Dealer Application

Name: Gemstone Lights
Address: 11080 50 Street SE #170, Calgary, AB, T2C 5T4
Telephone: (403) 450-0083
Price range: $$$

Name*
First Last
Email*
Phone*
Company Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code 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 products
Do you currently have a business relationship with an existing Gemstone Lights Dealer?*
If 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