Become a Dealer

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Dealer Details

Name *

Email *

Phone

Mobile Phone *

Dealership Details

Company Name *

Company Registration No *

Trading Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

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Website

VAT Number

RAV Secure Registration Scheme & number

Company Introduction

Brief Company Outline *

No. of Sales Staff *

No. of Technical Staff *

Workshop *Please SelectYesNo

Brands currently being dealt with *

Past & Current Activities in the Power Sports or Automotive Industry *

Social Media Handles

Facebook

Instagram

TikTok

Point of Contact (POC)

Sales & Marketing Name

Technical Name

Parts Name

Sales & Marketing Phone

Technical Phone

Parts Phone

Sales & Marketing Email

Technical Email

Parts Email

Motivation for Joining Urban Moto Dealer Network *

Saler Territory Definition

Number of Showrooms *123 or more

Showroom Location – 1 *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Showroom Location – 2 *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Showroom Location – 3 *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

City / Towns to Cover

• Bath
• Birmingham
• Bradford
• Brighton & Hove
• Bristol
• Cambridge
• Canterbury
• Carlisle
• Chelmsford
• Chester
• Chichester
• Colchester
• Coventry
• Derby
• Doncaster
• Durham
• Ely
• Exeter
• Gloucester
• Hereford
• Kingston-upon-Hull
• Lancaster
• Leeds
• Leicester
• Lichfield
• Lincoln
• Liverpool
• London
• Manchester
• Milton Keynes
• Newcastle-upon-Tyne
• Norwich
• Nottingham
• Oxford
• Peterborough
• Plymouth
• Portsmouth
• Preston
• Ripon
• Salford
• Salisbury
• Sheffield
• Southampton
• Southend-on-Sea
• St Albans
• Stoke on Trent
• Sunderland
• Truro
• Wakefield
• Wells
• Westminster
• Winchester
• Wolverhampton
• Worcester
• York
• Armagh
• Bangor
• Belfast
• Lisburn
• Londonderry
• Newry
• Aberdeen
• Dundee
• Dunfermline
• Edinburgh
• Glasgow
• Inverness
• Perth
• Stirling
• Bangor
• Cardiff
• Newport
• St Asaph
• St Davids
• Swansea
• Wrexham

Projected Sales Units *

Per month or year *MonthYear

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