Become a Dealer

Territories are closing fast! Don't miss out on this opportunity to be your own boss, set your own hours and build your wealth as a Mirage Waterless Grass™ dealer. Dealerships start at only $2,495. In certain circumstances, if you are a licensed landscaper or a licensed contractor, we may waive our Dealership Fees. Please complete the form below and contact us directly by telephone for requirement information.

Contact Information
* Denotes a required field

Salutation: Mr. Mrs. Ms.
* First Name:
* Last Name:
* Address:
* City:
* Local County:
* State:
* Zip:
Country:
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* Email:
* Best Contact Phone Number:
  Business Home Cell
* Alternate Contact Phone Number:
  Business Home Cell

Personal Information
Your age:
Marital status: Single Married
Spouse's Name:
* How did you hear about us?

Business/Work Experience
*Present Occupation:
* Have you ever been convicted of a felony crime? Yes No
* Have you previously owned and operated your own business: Yes No
If so, what type of business:

Financing Business
* Are you in the present position to invest
$3,995 to $14,995 to become a dealer? 		Yes No
Own home? Own Rent
*I am looking to potentially invest in your Distributorship program:
Immediately
Within 30 Days
Within 60 Days
Within 6 Months
Uncertain
*I am interested in securing a territory in:
*I am most interested in: Program #1
Program #2
Uncertain
Please send me more information on being a Mirage Waterless™ Grass dealer.
Please have a dealership representative contact me immediately to discuss my territory.

* I agree to the confidentiality terms

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