Become a Dealer – CH4X4 Industries

Registration

Username*

Email*

Password*

Customer billing address

First Name *

Last Name *

Company *

Address line 1 *

Address line 2 (optional)(optional)

City*

Postcode / ZIP *

Select billing country *

State / County / Province *

Phone *

Customer shipping address

Copy from billing address

First Name *

Last Name *

Company (optional)

Address line 1 *

Address line 2 (optional)(optional)

City *

Postcode / ZIP*

Select shipping country (optional)

State / County / Province *

EIN / Tax ID or License number: *

File Upload: (In order to approve your account, if your company is registered in the United States, you must attach a copy of your EIN and TAX ID number through the “choose File” button. If your company is in another country, you must send us a certificate or commercial license issued by your country of origin) *