Company Name:


Slogan / Short Description:

URL of website:

Email Address:

Phone: Fax:

Physical Address / Location:

Mailing Address (if different):

Brands carried (list up to 20:


Check all of the following products you carry
sea kayaks
whitewater or surf kayaks
surf skis
sit-on-top kayaks
Euro-style paddles
Greenland style paddles
accessories
Other:

Check all of the following services you provide:
retail sales
mail-order / phone order sales
online sales
ship composite kayaks
ship polyethylene kayaks
ship paddles & accessories
provide test paddles
provide tours
offer instruction
Other:

Hours open for business:

Retail hours:

Detailed description of your shop 50 to 200 words. (See sample). If you already have a description on your website, provide the URL. Submit by email if your prefer):

Do you plan to submit articles for credit against the cost for listing on this site?
No thanks.
Yes, I will submit 1 article ($20.00 discount).

Do you plan to include a link to KayakShops.com?
No thanks.
Yes, I will include a link ($10.00 discount).

How would you like to pay the fee for listing on KayakShops.com
Check
Credit card

Thank you. We will contact you with payment details.