Amsoil Products Request Form

Amsoil Product Information and Catalog Request Form
Company Name	Optional
First Name	Required
Last Name	Required
Street Address or P.O. Box	Required
City	Required
State or Providence	Required
Zip Code	Required
Telephone Number	Required
Email Address	Required
Vehicle Make: Ford, Toyota, Dodge, etc	Required
Model: Explorer, 4runner, Dakota, etc	Required
Year of Vehicle	Required
Engine Size in Liters	Required
Two Wheel Drive or Four Wheel Drive	Required
Gasoline or Diesel Engine	Required
Number of Cylinders	Required
Further vehicle information	Optional
Motorcycles, boats, quadrunners, etc	Optional
Either of the following two choices will allow you to purchase Amsoil Products at Wholesale Prices Amsoil Dealership ($15/6 month or $30/year renewal fee) Preferred Customer ($10/6 month or $20/year renewal fee) If you choose the Amsoil Dealership option I will show you how to be able to purchase Amsoil Products at Wholesale for life with virtually zero out of pocket dealership renewal expenses. (The Fees will pay for themselves)
Amsoil Home Dealership or Preferred Customer	Required
Retail Store Owners must meet one of these three criteria to open up an Amsoil Retail Account: (Mail in with complete Application) Include valid Business Number when you turn in application Include copy of add in any known yellow pages Have registered business phone number which can be found in any known business directory
Retail Store Owners	Required
Business Owners must meet one of these three Criteria: (Mail in with completed Application) This is for private Company use only (Not for Resale) Business owners are allowed to Purchase Amsoil Products below Wholesale Include valid Business Number when you turn in application Include copy of add in any known yellow pages Have registered business phone number which can be found in any known business directory
Business Owners	Required