Interested in becoming a MarineNav dealer?

Business Name
Mailing Address
Physical Address (if different)
City
Province or State
Postal or ZIP code
Telephone number
Fax Number
Tax ID (if applicable)
Email Address
Company Website

Business Type:

Corporation Partnership Franchise Proprietorship Other

Please add me to the MarineNav Ltd email newsletter mailing list. I can receive html based emails, and I understand that this is an opt-in mailing list, which I can unsubscribe from at any time.

Your email address will be kept confidential and will be used only to send important product updates, and if selected, occassional newsletters with information on new products and services we may offer. We will never sell or otherwise provide your email address to any third party.

IMPORTANT — PLEASE READ CAREFULLY

  TERMS OF SALE ARE NET 30 DAYS

The applicant agrees to the above stated terms and agrees to pay interest on all invoices exceeding our terms of sale which are subject to a 2% interest charges per month (24% per annum).

The applicant also understands that we may be required to evaluate information from the applicant on an ongoing basis. The applicant consents to the collection, use and disclosure of credit related information and the disclosure of credit-related information to such organizations as credit bureaus, credit grantors, insurers, adjudicators and agents. The applicant also understands and agrees that if consent is revoked, the company may no longer have access to their credit facilities and the amount owing may become due and payable in full. Notwithstanding any revocation, the applicant agrees that the company may report the status of our account to the credit bureau and credit grantors.

I / we, the applicant (s) certify that all the above information to be true and complete.

Applicant     Title      Date