SCC TECH BIKE
NEW DEALER APPLICATION 
Established dealers without a login credential please email dealersupport@scctech.bike
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Sales Representative
Sales Representative
If applicable
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Contact First Name*
Contact First Name*
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Contact Last Name*
Contact Last Name*
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Shop Phone Number
Shop Phone Number
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Email*
Email*
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Shop Website
Shop Website
Bike Shop Information
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Bike Shop Name*
Bike Shop Name*
Files must be under 3mb.
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DBA (If Applicable)
DBA (If Applicable)
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Shop Address*
Shop Address*
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Shop Address Line 2
Shop Address Line 2
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State*
State*
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Zip Code
Zip Code
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Country*
United States
Country*
Tax Information

- Utah based stores please provide a Utah State Tax Commission Exemption Form TC-721 
- Provide Document in the field below or Email form to dealersupport@scctech.bike
*REQUIRED FOR UTAH BASED DEALERS, NON-UTAH OPTIONAL. ADDITIONAL INFORMATION MAY BE REQUESTED AT A LATER DATE.
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RESELLER LIC/TAX EXEMPT #
RESELLER LIC/TAX EXEMPT #
*REQUIRED FOR SALES TAX EXEMPT STATUS
Acknowledgement
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E-Signature*
E-Signature*
*Information Provided is Accurate and Complete
Agree to Minimum Advertised Pricing Policy*
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Special Notes
Special Notes
Set Up Password
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Password*
Password*
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Password Again*
Password Again*
Send me updates & special offers
PLEASE NOTE ADDITIONAL INFORMATION COULD BE REQUESTED PRIOR TO APPROVING APPLICATION.