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Customer Support: 1-888-967-6839
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Dealer Application Form

Thank you for your interest in becoming a Zoroufy® Dealer. Simply complete the form below and you will be contacted by Zoroufy to set up an account. Zoroufy only accepts applications from retailers and distributors of home products. Zoroufy will verify your company data before your account is established. A valid Retail Certificate Number must be faxed to us for verification purposes.
Fields marked with an asterisk (*) are required.
Contact Name *
Please enter your name.
Company Name *
Please enter your company name.
Street Address *
Please enter address.
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City *
Please enter a city.
State *
Please select a state.
ZIP Code *
Please enter a valid ZIP code.
Telephone Number * (xxx-xxx-xxxx)
Please enter a valid telephone number.
Fax Number
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Email Address *
Please enter a valid email address.
Retail Certificate Number
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Nature of Business
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Comments & Questions
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