Dealer application

Contact and business information

First name *

Last name *

Business name *

E-mail *

Phone number *Format: (000) 000-0000.

Street address *

Street address line 2 (optional)

City (optional)

State / Province (optional)

Postal / ZIP code *

# of locations *

Business profile

If other, please specify

Years in business

# of employees

Approximate annual revenue

Tank showroom square footage

What brands do you carry for tanks over 100 gallons?

Do you offer installation / maintenance services?

YesNo

How did you hear about us?

Annual tank sales by size

About how many tanks in the following gallon sizes do you sell a year?

Documents

Business registration upload

Valid ID upload

If you have any questions about our products, dealership, logistics or anything else, contact us at info@aquavim.com or 917-363-8851.

Enhance your tank selection and services

54-08 46th St
Maspeth, NY 11378

(718) 433 - 2698

info@aquavim.com