Dealer Program Dealer Program Application At SIRS Electronics Inc. (SIRS-E®), we provide dependable service and support for our partners in order to best serve your clientele. The core of our business is the manufacturing of LED linear lighting and DMX decoders. We extend our services with options for custom fabrications, assembly assistance, and sourcing services for project materials, controls, and complementary equipment. We have partnered with many control and lighting software developers to make sure our hardware meets the needs of the client. Our sales team is readily available to assist project reps, specifiers, engineers, architects, and consultants with project design needs and we can produce layout designs and schematics for installations and your installers. On the control end, SIRS-E® offers programming services to further develop desired effects and facilitate functions unobtainable by your typical hardware. If you are ready to proceed, please fill out and submit the form below and someone will get back to you within three business days. Business InformationCompany Name*Login Username*Choose a username to login. 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If you don't have a digital image of your certificate , you can take a picture with your smart phone or camera. Please be sure it is a clear picture so we can read all the details.Upload a copy of your business license or cerificate*Accepted file types: jpeg, jpg, gif, png, pdf.You can upload a PDF, JPEG, JPG, GIF or PNG of your license or certificate. If you don't have a digital image of your license or certificate, you can take a picture with your smart phone or camera. Please be sure it is a clear picture so we can read all the details.Type of Projects (Check One or More)* Commercial Entertainment Marine Residential Retail Vehicle Other Other - Types of Projects*Please provide a short description of what it is that your business provides and what your usual needs consist of:*Business ReferencesReference 1Company Name*First Name*Last Name*Phone Number*Contact Email* Reference 2Company Name*First Name*Last Name*Phone Number*Contact Email* Project InformationWill you be requiring any Design or Engineering Assistance?*No - We will only be requiring a purchasing portal with no assistanceYes - We will require assistanceProvide Purchase Order Upload or a List?*Purchase Order UploadListProvide List (Include item(s) and its corresponding qty(s)Provide Purchase Order Upload*Accepted file types: pdf, jpg, gif, jpeg, png.You can upload a PDF, JPEG, JPG, GIF or PNG of your purchase order.Design and Engineering Assistance will require a non-refundable Design/Engineering Deposit. Do you agree with this?*NoYesWe do not require you to pay a Design / Engineering Deposit if you do not require the service. Please provide a Purchase Order Upload or a List of required items.*Purchase Order UploadListProvide List (Include item(s) and its corresponding qty(s)*Provide Purchase Order Upload*Accepted file types: pdf, jpg, gif, jpeg, png.You can upload a PDF, JPEG, JPG, GIF or PNG of your purchase order.We primarily work with experienced lighting designers and licensed electricians/installers. We guarantee to provide assistance with the design, necessary components, and general setup instructions to complete your project(s). We can also offer wiring diagrams (if necessary) upon purchase. If your assistance level falls far outside the scope of these specified parameters, we may require a technical assistance fee. This fee is rarely applied but is necessary in instances of excessive time allotment for unexperienced installers. Do you agree with this?NoYesWe are more than happy to assist you with your project. Keep in mind that we will only be providing you with the design, necessary components, and general setup instructions to complete your project(s). We can also offer wiring diagrams (if necessary) upon purchase.Project BudgetBrief Description of your projectRelevant Pictures/Diagrams/Drawings Drop files here or Accepted file types: jpg, gif, png, jpeg, pdf. Electronic SignatureElectronic Signature: (Type your name)*Date* Date Format: MM slash DD slash YYYY Electronic Signature Authorization* I understand that checking this box constitutes that the name in the box above is my name, and it is a legal signature confirming that all of the information provided above is correct and truthful. Captcha This iframe contains the logic required to handle Ajax powered Gravity Forms.