Retailer Interest Form

For future consideration, please provide the following information in the form below

Due to high volume leading up to our statewide launch we there may be delays of up-to 60 days to be added to our approved retailer site. We will review entries on a regular basis and reach out with next steps.

NOTE: This is not the retailer application.

Name *

First

Last

Email *

URL California Retailer

Business Name or DBA *

California Eligibility Address *

Address Line 1

Address Line 2

City

State

Zip Code

Website / URL *

Type of Retailer *

Do you carry eligible e-bikes?

Retailer Interest Form

For future consideration, please provide the following information in the form below

How It Works

About

Resources

FAQs

Retailer FAQs

CONTACT US