Become a Dealer

Distributor Application Form

If you are interested in becoming a distributor for ICON Vehicle Dynamics, please read and fill out our online application form below in its entirety.

We also have a Printable Form: Click Here to Download the PDF. (Fax completed form to 951-689-1016)

Thank you!
  • Company Info

  • Example: 9516894266 (NO SPACES)
  • Example: 95-123456
  • Sales Info:

  • Contact Info:

  • In order to complete this application, a copy of your Re-Sale Card and Business License MUST be faxed in to 951-689-1016. All orders will be shipped PrePaid. For open account terms, a Credit Application must be completed and approved by the ICON Vehicle Dynamics Accounting Dept.
  • 7929 Lincoln Ave. Riverside, CA 95204 | ph. 951.689.ICON | fx. 951.689.1016
  • This information may be shared with an authorized ICON distributor, completion of this form and clicking ‘Submit’ indicates you agree to these terms.