Surveilux Security Camera & Video Surveillance Systems

If you are a dealer, integrator or security distributor interested in becoming a Surveilux partner please submit the application form below for approval. A Surveilux representative will contact you within 3 business days of your application.

First Name
Last Name
Company
Title
Address
Address 2
City
Zip Code
State
Country
Office Phone Number
Email
Cell Phone Number
Year Estabilshed
No. Of Employees
Nature of Business
Dealer
Distributor
Integrator
Sales Representative
End User
Expected Monthly Purchases:
1-10,000
10,000-50,000
50,000 - 100,000
> 100,000
Where did you hear about us?
Security Dealer
Mailing
SDM
Website
Search Engine
Other
Comments
Current CCTV Vendors
= Required