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Distributor Application Form

If you are interested in becoming a distributor for ICON Vehicle Dynamics, please read and fill out our online application form below in its entirety.

We also have a Printable Form: Click Here to Download the PDF. (Fax completed form to 951-689-1016)

Thank you!

Company Info

Sales Info

Contact Info

In order to complete this application, a copy of your Re-Sale Card and Business License MUST be faxed in to 951-689-1016. All orders will be shipped PrePaid. For open account terms, a Credit Application must be completed and approved by the Icon Vehicle Dynamics Accounting Dept.

7929 Lincoln Avenue, Riverside, CA 92504 | Phone: 1-951-689-4266 | Fax: 951-689-1016

This information may be shared with an authorized ICON distributor, completion of this form and clicking ‘Submit’ indicates you agree to these terms.

* All Fields Required

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