Quick Wholesale Account Setup

Just fill out this form and we’ll have your purchasing account ready in no time..

Distribution Partner Setup

Company Name*

What is the main phone number for this location?*

Who is the main contact for your location?*

Main Contact Email Address*

Title of Main Contact*

Billing Address - Street*

Billing Address - City*

Billing Address - State*

Billing Address - Zip Code*

Is this location Tax Exempt?*

Yes

Exemption number (if tax exempt)

If Exempt - Upload Tax Exempt Certificate

Choose file

Would you like to apply for a credit account?*

Yes

The location is part of a central purchasing group

Accounts Payable Contact Name*

Accounts Payable Contact Email*

Accounts Payable Contact Phone Number*

Shipping Address - Street*

Shipping Address- City*

Shipping Address - State*

Shipping Address - Zip Code*

Who should we contact to schedule deliveries?*

Email address for delivery scheduling contact.*

Phone number for delivery scheduling contact.*

Can your location accept a 53ft tractor trailer for deliveries?*

Yes

Who is the locations main purchasing contact?*

Email address for main purchasing contact.*

What is the phone number for the main purchasing contact?*

Do you have a preferred repair technician? if so, please let us know their business name and the best form of contact.

Which Jetta Representative have you been working with?*

Are there any additional people on your team that would benefit from role based onboarding emails. If so, Provide Name, Role and Email addresses