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New Fleet Registration

If you're considering becoming a Bridgestone Firestone National Accounts customer, you can apply online instantly—there's absolutely no obligation. Please provide us with the information below, and a sales representative will contact you shortly. All information is kept strictly confidential. Your privacy is important. Privacy Information

STEP 1: Enter Company Information

Company Name:

Subsidiary of:

Type of business:

Address:

Address 1:

State:

City:

Zip:

Phone:

Fax:

STEP 2: Enter Contact Information

First Name:

Middle initial:

Last Name:

Email Address:

Phone:

Fax:

Do you currently use other tire and service national account programs?:

Yes No

If "Yes", please list programs:

Your purchasing is:

Centralized Decentralized

Are you the purchasing contact?:

Yes No

If "No", please provide:

Contact name:

Contact phone:

STEP 3: Enter number of vehicles

Passenger:

Light truck:

Other:

If "Other", please explain:

STEP 4: Enter Estimated Annual Purchases

Tires: $

Services: $