Exclusive Dealer

Thank you for your interest in becoming a Mobilicity Exclusive Dealer.  Please complete the form below.


Exclusive Dealer Information Form
* First Name
* Last Name
* Street Address
* City
* Province
* Postal Code
* Phone Number
* Email Address
* Do you currently have a retail location?
   
How many retail locations do you currently have?
Do you currently own a business?
   
If yes, please describe your current business.
How many Mobilicity Stores are you interested in opening?
Do you have any potential addresses you would like us to consider for dealer status?
   
Who would be your target customer?
Why would you like to invest in becoming a Mobilicity exclusive dealer?
Do you have experience selling wireless services in a retail environment?
   
If yes, how many years?
Please list all your store names and addresses:
What kind of products and services do you currently offer?
Is your intention to convert all your current retail locations to exclusive Mobilicity dealers?
   
What language(s) do you currently speak to serve your customers?
Do you have any experience selling wireless services in a retail environment?
   
If you do, how many years?
Why do you want to invest in becoming a Mobilicity exclusive dealer?
Do you own other businesses not listed above?
   
If yes, please describe your other businesses.