Cansec Dealer Application and Agreement Form

Thank you for your interest in becoming a Cansec authorized dealer. Please complete and submit the following application form to assist us in our evaluation of your company. All information received will be held in confidence.

Please note that we require first orders to be paid via credit card before upon processing.

* is required field.

Dealer Application
General Information
Business Type

Sales Manager
Accounts Payable
Business Operations
Systems Installed
30-Day Terms
Bank References

Please right click HERE to save link as ... / save target as ... , fill the Cansec Bank Reference Form and upload this completed form.

Trade References
Supplier 1
Supplier 2
Supplier 3