Dealer Request Form

Thank you for your interest in becoming a Chicago Scooter Company Authorized Dealership. We are currently accepting applications from established 2-wheel vehicle dealers only. Please fill out the form below and a CSC representative will contact you as soon as possible.

All the information below is required

Contact Information:

* First Name:

* Last Name:

* Email Address:

* Phone:

Company Information:

* Company Name:

* Web Site Address:

* Address:

* City:

* State:

* Zip:

* Phone:

* Fax:

* Showroom Size (sq. feet):

* Financing Company (GE, Textron, DSC):

* Brands Sold:

* Years In Operation:

Dealer Request Form

Contact Information:

Company Information:

Scooters.

Dealers

Information