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StayNu
Dynamic Glass
Dynamic Wheel
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



StayNu Dealer Information Sign Up Form

Click here to use the PDF version  (please fax to 770- 326-9935)

 

Asterisk (*) denotes required field

*Legal name:                Group name:       

*Email:                           *Dealership DBA:

*Physical Address:      *City:                     

*State:                           *ZIP Code:            

Mailing Address (if different)

Dealer Principal:

Controller:          

Office Manager: 

Phone Number:  

Fax Number:       

Tax ID Number:   

_________________________________________________________________________________________

*Name and Title of Person Signing Agreements:

General Manager:  

Sales Manager:       

F&I Director:            

Service Manager:   

Programming:          

Website Address (if available):

_________________________________________________________________________________________

Primary Contact Person

Agency:                   Phone:

Dealership:             Phone:

Please send agreements to: Agent   
                                                  Dealership

  

Please send supplies to:       Agent
                                                  Dealership
                                               

  

 

 

 

 

If sending to agent, please submit the following:

Name:     

Address:

Phone:   

_________________________________________________________________________________________

*Effective Date:         Installation Date:           

Rep/Agent:                StayNu Policy Number:

 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



Dynamic Glass Dealer Information Sign Up Form

Click here to use the PDF version  (please fax to 770- 326-9935)

 

Asterisk (*) denotes required field

*Legal name:                Group name:       

*Email:                           *Dealership DBA:

*Physical Address:      *City:                     

*State:                           *ZIP Code:            

Mailing Address (if different)

Dealer Principal:

Controller:          

Office Manager: 

Phone Number:  

Fax Number:       

Tax ID Number:   

_________________________________________________________________________________________

*Name and Title of Person Signing Agreements:

General Manager:  

Sales Manager:       

F&I Director:            

Service Manager:   

Programming:          

Website Address (if available):

_________________________________________________________________________________________

Primary Contact Person

Agency:                   Phone:

Dealership:             Phone:

Please send agreements to: Agent   
                                                  Dealership

  

Please send supplies to:       Agent
                                                  Dealership
                                               

  

 

 

 

 

If sending to agent, please submit the following:

Name:     

Address:

Phone:   

_________________________________________________________________________________________

*Effective Date:         Installation Date:           

Rep/Agent:                StayNu Policy Number:

 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 



Dynamic Wheel Dealer Information Sign Up Form

Click here to use the PDF version  (please fax to 770- 326-9935)

 

Asterisk (*) denotes required field

*Legal name:                Group name:       

*Email:                           *Dealership DBA:

*Physical Address:      *City:                     

*State:                           *ZIP Code:            

Mailing Address (if different)

Dealer Principal:

Controller:          

Office Manager: 

Phone Number:  

Fax Number:       

Tax ID Number:   

_________________________________________________________________________________________

*Name and Title of Person Signing Agreements:

General Manager:  

Sales Manager:       

F&I Director:            

Service Manager:   

Programming:          

Website Address (if available):

_________________________________________________________________________________________

Primary Contact Person

Agency:                   Phone:

Dealership:             Phone:

Please send agreements to: Agent   
                                                  Dealership

  

Please send supplies to:       Agent
                                                  Dealership
                                               

  

 

 

 

 

If sending to agent, please submit the following:

Name:     

Address:

Phone:   

_________________________________________________________________________________________

*Effective Date:         Installation Date:           

Rep/Agent:                StayNu Policy Number: