Brick & Mortar Dealer Application

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Business Basics

Is this a New or Existing Business? *

New
Existing

How Did You Hear About Us? *

Type of Retail Business *

Wireless/Cellphone Store
Electronics Store
Computer or Repair Shop
Multi-Service or Convenience Store
Other Retail Store

Single Line Text *

Company Name *

DBA

Address *

Address Line 1

City

State

Zip Code

Phone *

Store Email *

About Your Owner

PLEASE PROVIDE A VALID MOBILE NUMBER. APPLICATION STATUS UPDATES WILL BE TEXTED TO YOU.

Principal #1

Principal #1 *

First

Last

Phone *

Email *

Principal #2

First

Last

Phone

Online Presence

Do you have a company website? *

Website / URL *

Is your Company listed on Google Maps? *

Google Maps URL *

Is Your Company Listed on Yelp? *

Yelp URL *

Is your company on Facebook? *

FB URL *

Are you on any of the following platforms? *

I Don't Sell On Any Marketplace
Facebook Marketplace
OfferUp
Craigslist
Other Marketplace

Explain Other *

Store Profile Questionnaire

What Cellphone Brands do you currently sell? *

Verizon
AT&T Wireless
T-Mobile
Metro By T-Mobile
Cricket
Boost Mobile
Total Wireless
Simple Mobile
Verizon Prepaid
AT&T Prepaid
T-Mobile Prepaid
Ultra Mobile
MobileX
H2O Wireless
Lycamobile
Other prepaid brands

Have you ever sold or worked for a cable or internet provider (e.g., Spectrum, Xfinity, AT&T)? *

If Yes, which provider(s), and what was your company name? *

Do You Currently Sell any other Internet/Cable/Satellite Brand? *

What Internet/Cable/Satellite Brands Do You Currently Sell? *

What Is The Top Brand You Sell? *

About How Many Units Do You Sell Per Month? *

How Do You Plan On Marketing Internet & Mobile Services In Your Store? *

Do you have employees?

How Many Employees Do You Currently Employ?

What Type Of Employees Do You Employ?

Retail/In Store
Door to Door
Telemarketer
Business to Business
Other

Do you have business insurance?

Who is your business insurance provider?

Documents & Photos

If you upload documents now, we won't have to request them later, and your application will be approved faster.

Drivers License / Govt Issued ID

Drag & Drop Files, Choose Files to Upload

Re-seller Permit / Business License ONLY (Must match company address on application)

Drag & Drop Files, Choose Files to Upload

Store Exterior Pic (Street View)

Drag & Drop Files, Choose Files to Upload

Store Interior Pic 1–4 (From Corners)

Drag & Drop Files, Choose Files to Upload You can upload up to 8 files.

By checking this box I understand that this application is subject to carrier and Vomtel approval. Failure to submit location pictures, permit/business license, driver's license, and complete training within 7 days of this submission will result in automatic denial of your application.

Field #34 (copy) *

By checking this box I acknowledge and agree to the use of my contact information to receive text messages, emails, or calls about product/service updates, offerings, or promotional alerts by Vomtel, its brands, affiliates and/or third-party partners, consistent with Vomtel's Privacy Policy.

currently Per any