Authorized Installer Setup Fill out the form below to request setup for your Installer as a DuraMAX Authorized Installer. Questions? Contact UsHiddenPost Title Distributing Company* RELADYNE Sales Rep Name* Sales Rep Email* Installer DataData entered in this section will be how the Service Certificate checks will be payable and how the Installer will be listed on the Locator Map.Installer Company Name* Street Address* City* ST* Zip Code* Installer Phone NumberIf included, will be listed on Locator.Installer Website (include http://)If included, will be listed on Locator. The following information is used for notifications and record keeping.Installer Contact Name* Installer Contact Email Address* Account Number Program ParticipationSelect the DuraMAX Programs in which the Installer will participate.* Select All DuraMAX DOLLAR$ Program Engine Warranty Program List this Location on DuraMAX.com AcknowledgementRequesting setup of your Installer through this form does not trigger Point of Sales Materials to be sent.* I acknowledge that I will need to work with my Marketing Department to order Point of Sale Materials to support these Programs. CommentsThis field is for validation purposes and should be left unchanged.