• *First Name : *Last Name :
    Position :    
    Company Info
    *Company Name : Registered Company Name :
    Date Businesses Commenced : *Phone :
    Website : * Principal's/Owner's Name:
        *Projected Annual Purchases :
    How many product lines (manufactures) displayed in showroom : Remodel or new construction :
    Design software used : * Email Address :
    Address : Address2 :
    City : State :
    Zip :
    Billing Info
    Billing Contact Name : * Billing Contact Phone Number :
    * Billing Contact Email Address :
    *Billing Address : Billing Address2 :
    * Billing City : *Billing State :
    *Billing Zip :
    Shipping Info  
    Order Contact Name : * Order Contact Phone Number :
    * Order Contact Email Address :
    *Shipping Address : Shipping Address2 :
    *Shipping City : *Shipping State :
    *Shipping Zip :
    Please enter your payment information for one of the below dealer startup kits. If your application is accepted, you will be charged the appropriate price for the kit selected. You will be provided discount coded useable on future purchases in the amount of the kit selected below. Please contact us for details.
    Item Description Price Select
    DSBK-Technik Technik Door Sample Bag Kit
    • molding sample chain
    • 1 pack of 50 brochures
    • 5 sample doors
    • 1 full set of door backers
    • Misc Hardware
    		 $200.00
    DSBK-AWC All Wood Cabinetry Sample Bag Kit
    • molding sample chain
    • 1 pack of 50 brochures
    • 1 full set of sample doors
    • 1 full set of door backers
    • Decorative Hardware
    		 $250.00
    AWDMR302584-KCB Kitchen Merch. 33"wx25.5"dx84"h KCB $500.00
    AWDMR302584-LTG Kitchen Merch. 33"wx25.5"dx84"h LTG $500.00
    AWDMR302584-HBG Kitchen Merch. 33"wx25.5"dx84"h HBG $500.00
    AWDMR302584-RMG Kitchen Merch. 33"wx25.5"dx84"h RMG $500.00
    AWDMR302584-LCN Kitchen Merch. 33"wx25.5"dx84"h LCN $500.00
    AWDMR302584-LCB Kitchen Merch. 33"wx25.5"dx84"h LCB $500.00
    AWDMR302584-HCN Kitchen Merch. 33"wx25.5"dx84"h HCN $500.00
    AWDMR302584-FMG Kitchen Merch. 33"wx25.5"dx84"h FMG $500.00
    AWDMR302584-NPW Kitchen Merch. 33"wx25.5"dx84"h NPW $500.00
    AWCStarterKit
    • molding sample chain
    • 1 pack of 50 brochures
    • 1 full set of sample doors
    • 1 full set of door backers
    		 $150.00
    *Payment Type: *Name On Card:   
    *Credit Card Number: *Expiration Date:  
    *Security Code: