Dealer Portal Registration

Hello! Please use this page to register for the Blaze Dealer Portal!

Note: Authorized Blaze Dealers only. We will be approving everyone who registers for this portal. If you are approved and misuse the materials we are providing in any way, you will be immediately removed.

Business or Client Name is required
Contact Name is required
Invalid Email, proper format "[email protected]" Email is required
For example, CEO, Owner, Secretary, Sales Manager, Marketing, etc.
What is your position title? is required

Please let us know what Distributor you use.
Distributor Used is required
If you checked "other" for distributor used, please enter your distributor here. (If you do not enter a distributor you will not be approved.)

What Blaze products are you displaying? (Please check all that apply) is required

Would you be interested in adding to your display? is required

Are you open to the public? is required
Please enter your store address is required
Zip Code is required
City, State is required

Username is required
Password is required
Confirm Password is required

>> HINT: The password should be at least seven characters long. To make it stronger, use upper and lower case letters, numbers and symbols like ! " ? $ % ^ & ).
  Check to Enable
Privacy Policy is required

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