Dealer Application

Quarq Technology looks forward to establishing growing partnerships with businesses looking to continue or start promoting training and racing with power.

Please complete this application form and attach the necessary credentials to be considered as a Quarq Dealer. Once approved, you will receive instructions to begin ordering Quarq products.

Fields followed by an * are required items.

General information

Business name *
Type *
Years in business *
Weekly business hours *

Credit Card Billing information

Address *
Address 2
City *
State *
Zipcode *
Phone *
Fax
Billing email * Primary email for correspondence
Website

Shipping information

Address *
Address 2
City *
State *
Zipcode *
Phone *
Fax

Other Shipping Addresses

Optional additional shipping addresses.

Address
Address 2
City
State
Zipcode
Phone
Fax

+Add address

Owner/principal

Name *
Home address *
Home address 2
City *
State *
Zipcode *
Primary contact *
Owner email *
Phone *

More information

Other brands sold *
- PowerTap
- SRM
- iBike
- Polar
- None
- Other
Estimated number of CinQos * Estimated number of CinQos you will sell in the next 12 months
Tax identification *
Dealer license *

Dealer Confirmation
There are two ways to confirm your status as a dealer. Choose one or the other:

1) Enter your QBP account number

QBP account number

--------- OR ----------

2) Upload a current phone bill showing the company name, a uniform sales and use tax certificate, and commercial location photos showing your signage, showroom floor, and workshop.

Phone bill Current phone bill showing company name
Uniform sales Uniform Sales and Use Tax Certificate
Commercial location photos
+Add file

Click here to view the terms of this agreement
Agree to terms *