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Create Your Account
Please enter your information below, we look forward to working with you!
Create Your Account
Please enter your information below, we look forward to working with you!
First Name*:
Last Name*:
Email*:
Job Title:
Office Phone Number*:
Mobile Number:
Preferred Method of Contact*:
Email
Office Phone Number
Mobile Number
Company Legal Name*:
Company DBA:
Shipping Address:
Country*:
United States
Canada
State/Province*:
City*:
Zip Code*:
Address 1*:
Address 2:
Billing Address:
Using Shipping Address
Country:
United States
Canada
State/Province:
City:
Zip Code:
Address 1:
Address 2:
Website:
Number Of Employees:
Primary Industries:
Banking & Finance
Business Other
Culture, Education, & Healthcare
Energy
Government
Industrial & Logistics
Justice
Real Estate/Building
Retail
Smart City
Smart Policing
Traffic Management
Transportation
Secondary Industries:
Annual Purchase Amount (USD):
Preferred Authorized Distributor:
Aartech Canada Inc
ADI HQ
Advantage Electronics Wire & Cable
Alarm Products Distributors Inc.
AVX Technology Warehouse
Brooklyn Supply
Electracom Supply Inc
Electronic Supply Company
Esentia Systems Inc
Gescan
Graybar Canada
Green Mountain Electric Supply
Lone Star Systems Supply, LLC.
Low Voltage Direct
Nodac Technology
ROC Supply
SECURITY SALES AND SOLUTIONS, INC
Security Supply Inc
SES HQ
STS Lab (CCTV.NET)
Systems Distributors Inc (SDI)
Target Distributing
United Digital Technologies
GVS
Tax ID (EIN) Number:
As part of the program, if the total amount equals to $600 or more annually, it is required to report the “Form W-9.” To comply with the requirement by the IRS, please provide the following information:
W-9 Form:
*Amount is based on partner level
Seller's Permit:
Resale Certificate:
Please note: Luminys dealers without a valid seller’s permit or resales certificate will not be able to access the checkout section of Luminys Dealer Portal storefront.
Focused Groups:
Veteran owned business
Minority owned business
Women owned business
Applicants will need to submit an eligible document to qualify your status. E.g. “From 214” for veteran-owned business, certification from the National Women Business Owners Corporation (NWBOC) or the Women’s Business Enterprise National Council (WBENC) or certification from the National Minority Supplier Development Council (NMSDC). Luminys Technology USA has the final right to accept your application based on the submitted documents.
How did you hear about the Dealer Program?*:
ADI Expo
Regional Event
Distributor Event
Dealer Event
Luminys Sales Team
Luminys Website
LinkedIn
Tradeshow
Others
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