Registration

Company Name *

Street Address *

Address Line 2

City *

State *

Postal/ZIP code *

Country *

Phone number *

Fax Number

Email * This will also be your username for your Aimpoint Dealers Online Ordering Account.

Marketing Email * Email used for marketing communication.

Website *

Purchaser's First Name *

Purchaser's Last Name *

Purchaser's Email *

Purchaser's Phone Number *

Payable Contact First Name *

Payable Contact Last Name *

Accounts Payable Email *

Tax ID Number

Primary Business Type *

Check All That Apply

We do business on the Internet

We have a retail storefront

We have an FFL

We publish a catalog

This application is for a bid.

We have range facilities.

Are you a member of one of the following Buying Groups?

Sports Inc.

Worldwide

NBS

None

If you selected a Buying Group in previous question, please enter your respective Buying Group Account #:

How long have you been in this business? *

List a few other brands carried, optics and firearms: *

Please list two industry references: *

Describe your business: *

Please attach an electronic file version of your Resale Tax Exemption Certificate (ALL states except AK, DE, MT, NH & OR)

Please attach electronic copy of your “behind the counter” State Tax Registration Certificate.

Payment Preference

Professional Dealer Application