Dealer Sign-Up

If you are already using Electro’s products or intend to go through our training process, you can sign up as a qualified product installer. If you are interested in signing up to receive training or would like to get a dealer account set up, complete the sign-up form either by email or by printing out and mailing the form. Our mailing address is listed at the bottom of this page.

Signup Form

		* required
Customer Code
*Company Name
*Address
*City
*County
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*Zipcode
*Phone Number
Fax Number
*Contact Name
Email address
Web Page		http://
*Primary Brand Name Products
Primary business		Choose One Electrical HVAC Plumbing Other
Preferred Distributor in your area
Address
City
State/Prov		(select one) Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Newfoundland Nevada New Brunswick New Hampshire New Jersey New Mexico New York Northwest Territories North Carolina North Dakota Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon
Zipcode
Primary contact

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