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You are here: Home > BECOME A DEALER
Would you like to carry Blackworks items in your store? 

Please  Click Here To Download our new dealer application, You can send this back to:
      - Via Fax (951) 848-9977
      - Email sales@bwrusa.com 



OR you can submit this online inquiry to have one of our sales representatives contact you shortly. 
Please fill out the following information, you will be getting contacted by a account manager within 24 Hours.
Company Name:      
Address Info:
Physical Address :
City: State: Zip Code:
Phone: Fax:
Email Address:

Buyers Name?

Basic Questionnaire:
Do you currently carry Blackworks Products?
Yes No
(IF) Yes were do you purchase from ?

Do you have a website?
Yes No
(IF) Yes , What is your website domain name?

Do you have a retail storefront?
Yes No

How did you hear about us?



Please enter the following code into the box provided: