Dealer Application Form

We value our relationship with our retail network.

Aggressive discount structure to help grow your business
No minimum purchase requirement
Discounted shipping rates
No drop ship fees
Personalized marketing services for your print needs
Friendly and professional sales staff
Sales training and tools

Want to become a Dealer?

Thank you for your interest in becoming an official dealer with Excelcia Music Publishing. Please complete the information below and a representative will contact you.

Company Name*
Tax ID #
Company Address (Billing)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Shipping Address (if different from Billing Address)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company Phone*
Name of Contact*
First Last
Contact Position/Responsibility
Contact Email*
Contact Phone (including extension)*
Accounts Payable Contact Person
Name
Accounts Payable Email Address
Website
Facebook
Twitter
Instagram
Do you have multiple locations?*
- Yes
- No
Multiple Location Addresses
Would you like automatic shipping of new releases?*
- Yes
- No
Please choose which New Releases you'd like automatically shipped to you.
- Band
- Jazz Ensemble
- Orchestra
- Choral
- Instruments Books