Dealer Application

Apply to Become an Authorized Dealer

Fill out the form below and our team will review your application and get back to you within 2 business days. All fields marked with an asterisk are required.

Business Information

Business name *

Business type *

Years in business

Business website

Business address *

City *

State *

ZIP code *

Contact Information

First name *

Last name *

Title / role *

Best time to contact

Email address *

Phone number *

Product Interest

Which product lines are you interested in carrying? *

Glass Block

HydroBlok Shower Waterproofing Systems

All product lines

Estimated monthly volume

How did you hear about Sierra Glass Block?

Do you currently carry any competing products?

Yes

If yes, please describe

Tell us about your business and why you want to become a dealer *

Legal

I confirm that I am an authorized representative of the business listed above *

I agree to be contacted by Sierra Glass Block regarding this application *

I authorize Sierra Glass Block to post the phone number above on its website

✓ Thanks — your application is on its way. We review applications within 2 business days.

Something went wrong and your application wasn't sent. Please try again, or call us at 916-455-5507.

Applications are reviewed within 2 business days. We will contact you by phone or email to discuss next steps. For immediate assistance call 916-455-5507.

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