Dealer Registration

Name (required)

Business name (required)

DBA (required)

Address 1 (required)

Address 2

City (required)

US state (required)

Zip code (required)

Mobile Phone (required)

Email (required)

Store type
---Big Box retailerC-storeChain storeWireless storeOther

What is your main interest?
Become a Wireless DealerBecome a Vibes DealerBecome a FreeUp Mobile DealerSell SIM ActivationsSell Cellphone Bundles

Account Type Desired?

1a. For Prepaid Account please complete the agreement Click Here (for Prepaid Account only) (required)*
CompletedNo, using Credit Account

2a. For ACH Account please complete the application Click Here (for ACH Account only) (required)*
CompletedNo, using Prepaid Account

*The documents listed in the links above are required to open your account. Please take a few minutes to complete the forms via Docusign (click the link to go to Docusign) and submit them before clicking “Send” and completing your registration

Check this box if you are currently an NWIDA member. (required)*
I am an NWIDA member.I am not a member.

Would you like to join the National Wireless Independent Dealers Association (NWIDA), or get more info on NWIDA?
NoYes

How did you hear about us? (required)
Account RepresentativeInternet AdPartner ReferralOther