Certified AmeriGlide Distributor

To begin the process of becoming a Certified Distributor Seller, please fill out the form below. Please do not call. After we have received your submission, we will contact you if you qualify for our program.

If you are granted an AmeriGlide Distribution center, a few of the benefits are...

Protected territory
AmeriGlide web site optimized for your particular territory
Inventory buy back program

Company Name
Legal Business Name
Owner's / Partner's / Member's Name
Business Street Address
City
State
Zip Code
Country
Phone
Fax
Purchasing Contact
Email Address
Date Present Business Began
Years At This Address
Type of Business
Type of Ownership
Website Address (if applicable)
Do you presently sell vertical lifts, stair lifts, elevators, dumbwaiters, lift chairs or scooters? If so, please list which ones.
What area do you service/install?
Please tell us why you are interested in selling AmeriGlide products.