Dealer Application

Become a dealer

Please fill out the application. Once received we will review and confirm your information. If you do not hear back from us within 24 hours please email info@flushmount.com. Once processed, you will receive a user name and password.

1-480-440-0140

    Name of Principle / Owner*

    Company

    Representative / Buyer*

    Email *

    Phone Number

    Years in Business

    Primary Sales Type:BuilderDesignerLighting Designer

    Showroom:YesNo

    Message