New Dealer Application

Future Tire is committed to providing our dealers with unmatched speed, service, and wholesale pricing on all of the popular brand name tires we carry. If you'd like to apply to be a new dealer, simply fill out the following form and click submit. We look forward to working with you and providing you with the best prices in the industry on wholesale tires.

Alternatively, you can download the new dealer application here, then fax the completed form to (516) 752-7944.

Company Information
Company Name:
Doing Business As:
Years in Business:
Street Address:
City:
State:
Zip Code:
Phone Number:
Fax Number:
Resale #:
Fed ID #:
E-mail Address:
Website Link:

Type of Business
Automotive Service	New Car Dealer	Independent Tire Dealer	Tire Manufacturer
Mass Merchant	Used Car Dealer	Regional Tire Dealer	Wheel Manufacturer
Vehicle Auction	Wholesaler	National Tire Dealer	Tuner/Accessories
Vehicle Manufacturer	Exporter	Company Owned Store	Warehouse Club
Other

Principle Information
Principle Name:	Social Security #:	Phone Number:

Home Address:	State:	Zip Code:

Bank Information
Bank Name:	Account #:	Phone Number:

Bank Address:	State:	Zip Code:

References
Reference #1 Name:	Reference #1 Address:	Reference #1 Phone #:

Reference #2 Name:	Reference #2 Address:	Reference #2 Phone#:

Reference #3 Name:	Reference #3 Address:	Reference #3 Phone#:

Online Setup
Would you like to be set up with an online account? Online access allows you to check prices, inventory, and place orders online.
Yes
Username:	Password:

How Did You Hear About Us?

Terms & Conditions - Read Before Continuing!

PLEASE FILL IN THE ABOVE IN ITS ENTIRETY & READ THE FOLLWING CAREFULLY AND CLICK AGREE WHEN DONE.

It is agreed to, by clicking agree below that all purchases from Future Tire Ltd., are due and fully payable by the 10th of the month (unless otherwise indicated on the invoice.) You also agree to pay any late charges for any overdue invoices at the rate of 1.5% per month (18% per Annum.). You accept full liability for any collection fees, legal costs and attorney fees, inclusively, deemed necessary to secure payment of any overdue invoice(s). I acknowledge that Future Tire Ltd. has provided me with notice, attached hereto, & make a part hereof, of my rights under the Federal Truth & Lending Act. The undersigned does personally guarantee full payment of all debts incurred in the name of the business & herby binds himself to all terms of this agreement, both individually & severally with the business.

Please enter your name as your online signature:
I have read the terms above and agree to the conditions stated.

Resale Certificates & Other Forms

If your business is located in New Jersey, Pennsylvania or Connecticut please download the appropriate Resale Certificate. New York Dealers Please download both NYS Resale Certificate and NY Waste Management form. Fax completed forms to (516) 752-7944.

*Downloads require Adobe Acrobat Reader