Use the form below if you’d like to enquire about becoming a dealer. Please enable JavaScript in your browser to complete this form.Dealer DetailsName *Email *PhoneMobile Phone *Dealership DetailsCompany Name *Company Registration No *Trading Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWebsiteVAT NumberRAV Secure Registration Scheme & numberCompany Introduction Brief Company Outline *No. of Sales Staff *No. of Technical Staff *Workshop *Please SelectYesNoBrands currently being dealt with *Past & Current Activities in the Power Sports or Automotive Industry *Social Media HandlesLayoutFacebookInstagramTikTokPoint of Contact (POC)Layout (copy)Sales & Marketing NameTechnical NameParts NameSales & Marketing PhoneTechnical PhoneParts PhoneSales & Marketing EmailTechnical EmailParts EmailMotivation for Joining Urban Moto Dealer Network *Saler Territory DefinitionNumber of Showrooms *123 or moreShowroom Location - 1 *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeShowroom Location - 2 *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeShowroom Location - 3 *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCity / Towns to CoverBathBirminghamBradfordBrighton & HoveBristolCambridgeCanterburyCarlisleChelmsfordChesterChichesterColchesterCoventryDerbyDoncasterDurhamElyExeterGloucesterHerefordKingston-upon-HullLancasterLeedsLeicesterLichfieldLincolnLiverpoolLondonManchesterMilton KeynesNewcastle-upon-TyneNorwichNottinghamOxfordPeterboroughPlymouthPortsmouthPrestonRiponSalfordSalisburySheffieldSouthamptonSouthend-on-SeaSt AlbansStoke on TrentSunderlandTruroWakefieldWellsWestminsterWinchesterWolverhamptonWorcesterYorkArmaghBangorBelfastLisburnLondonderryNewryAberdeenDundeeDunfermlineEdinburghGlasgowInvernessPerthStirlingBangorCardiffNewportSt AsaphSt DavidsSwanseaWrexhamProjected Sales Units *Per month or year *MonthYearSubmit