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Reseller or Distributor

If you would like to become an authorized reseller or distributor of Patriot products please fill out the form below.

Reseller Form
Distributor/Reseller Name*:
Website URL :
First Name*:
Last Name*:
Address*:
Address 2:
City*:
State/Province*:
Country*:
Postal Code*:
Email Address*:
Phone Number*: