Become A Rothco Dealer

Basic Information

Rothco Account Number*

Company Name *

Country *

Primary Resale Type *

Federal Tax ID # *

ASI #

In Care Of

Mailing Address 1 *

Mailing Address 2

City *

State/ Province *

Zip/Postal Code *

Location Type *

Please Take a Brief Moment to Describe Your Business *

Contact Information

Create An Account with Rothco

Email Address * {{errors.first('email_address') }}

Password * Min Requirements: 8 characters. 1+ capital letter, 1+ lowercase letter, 1+ special character

Confirm Password * {{errors.first('password_confirmation') }}

Primary Contact Name (Full Name) *

Primary Contact Title *

Business Phone Number *

Mobile Phone Number *

Additional Contact {{index + 1}}

Contact Name (Full Name) *

Contact Title *

Email *

Mobile Phone Number *

Additional Information

Company Founded On *

Companies Total Employees *

How Did You Hear About Rothco *

Please specify *

Company Total Annual Sales (US $) *

What % of Your Company's Sale are Outside the US *

Total Number of Stores *

Please Indicate the Number of Government Contracts You Have Successfully Fulfilled *

List any Government Websites on Which You Offer Product *

Please List the Percentage of Business Done on the Following Levels: *

Federal

State

Municipal/Local

Private

Company's Social Profiles

Please List All URLS Where You Plan on Featuring Rothco. Please Note Rothco Does Not Accept Any 3rd Party Sellers.

List Your Companies Top Three Suppliers/Vendors You Work With *

Outside the US, What Other Countries Do You Sell To? Please List

Please Take a Brief Moment to Describe Your End User *

Salesperson*

Do you screenprint, embroider or logo the products you sell? *

Yes No

Shipping Information

Add Shipping Location

Same As Mailing Address

In Care of *

Street 1 *

Street 2

City *

Country *

State/Province *

Zip/Postal Code *

Additional Shipping {{index + 1}}

In Care Of *

Street 1 *

Street 2

City *

Country *

State/Province *

Zip/Postal Code *

Retail Information

Add Retail Location

Same As Mailing Address

Same As Shipping Address

Same as mailing address

Same as shipping address

In Care of *

Street 1 *

Street 2

City *

Country *

State/Province *

Zip/Postal Code *

Resale Certificate (Companies based in the USA must upload a valid resale certificate for all ship to states to be approved as a Rothco dealer) {{errors.first('resale_certificate') }}

Resale Certificate No

Comments

I Accept Rothco's Reseller Agreement (En Español) Please accept our terms and condition by clicking checkbox above

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If you are experiencing issues completing this form please email DealerAcctSetup@Rothco.com

Rothco is not accepting applications for products to be sold on a digital marketplace, such as Amazon or eBay. All companies that wish to sell ROTHCO product online must have a fully functional ecommerce website that has been active for more than one year.

EMAIL US

1-800-645-5195

Basic Information

Contact Information

Create An Account with Rothco

Additional Contact {{index + 1}}

Additional Information

Shipping Information

Additional Shipping {{index + 1}}

Retail Information

New Arrivals

Email Us

1-800-645-5195