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  Producer Signup application

Thank you for your interest in becoming an INDS Canada producer. If you kindly provide us with the information requested below, we will be glad to respond to your needs.

 Producer Application
Name of Dealership
Street Address
City
Province
Postal Code
Contact Name
Title
Telephone Number
Fax Number
E-mail Address
Dealer Type
 Auto  RV  Motorcycle
 Marine  Others
Are you currently Selling Service Contracts? Yes   No
If Yes…
Please indicate the name of your current provider.
Please indicate the name of your current sales representative.
Please indicate the telephone number of your current sales representative.
Please indicate the number of contracts sold each month.  New    Used
If No…
Please indicate the number of vehicles you sell each month.  New  Used