Home Dealer Application General Information Which are you interested in applying for? DealerMask/Regulator Service - No Dealership Business Name Store Owner Store Manager Phone Fax Email Address Address 2 (optional) City State Zip Country —Please choose an option—United StatesCanadaAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArmeniaArubaAustraliaAustriaAzerbaijanAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaireBosnia and HerzegovinaBotswanaBouvet Island (Bouvetoya)BrazilBritish Indian Ocean Territory (Chagos Archipelago)British Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCura�aoCyprusCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKazakhstanKenyaKiribatiKoreaKoreaKuwaitKyrgyz RepublicLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Netherlands)Slovakia (Slovak Republic)SloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & S. Sandwich IslandsSpainSri LankaSudanSurinameSvalbard & Jan Mayen IslandsSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Virgin IslandsU.S. Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe Business Information Please note: All of these fields are required. Have you ever been an OTS Dealer? NoYes Type of Business? —Please choose an option—Retail SalesRepresentativeManufacturerOEMNon-ProfitSchoolCatalogE-commerce Resale License # Conduct Business as —Please choose an option—CorporationPartnershipSingle OwnerPart TimeOut of Home Business Hours Number of Employees Size of Business (Sq Ft.) Number of Stores Estimated OTS Sales Volume Annually Current Market Share Number of Competitive Stores in Your Area Please provide the following percentages of your total sales for each of the following: Internet Sales Retail Sales Sporting Goods Describe the nature of your business Scuba Lines Carried References Please list three references you are currently doing business with, and type of account established. All of these fields are required. Reference #1 Name: Type of Account Phone E-mail Reference #2 Name Type of Account Phone E-mail Reference #3 Name Type of Account Phone E-mail Files The Following Files are required to be scanned and uploaded to this form. Each file MUST BE LESS THAN 4MB. Photo of Resale License Please upload a photo of your Resale License Photo of Outside of Business Please upload a photo of the outside of your business Photo of Inside of Business Please upload a photo of the insideof your business Conclusion Your First Name Your Last Name Application Date Did you speak with an OTS Employee? I did not speak to anyoneKurt SchmidJohn HottDennis SakamotoAmie LitzingerYadira FloresAndy NelsonPeter GreenwellJoe TothAriana MaciasJennifer HollowellDoug Maynard All applications for dealership and credit accounts are subject to review and approval by OTS. Returning this application does not constitute nor imply acceptance of an OTS Dealership, Representation and/or any type of account authorization. In the event of a dispute over merchandise and/or payment, dealer is responsible for legal fees. All information submitted to OTS will be kept confidential.
