ENROLLMENT FORM
 

     


1. Enter your Kia Dealer Code and press the submit button.
2. Complete all applicable fields below and make corrections where necessary. 

3. When finished, click the ENROLL button at the bottom of the page to submit your enrollment request.

     

Dealer Code

   

 

General Information

 

Dealer Name  
Address  
City       State     Zip
Service Phone     Alternate Phone  
Sales Phone        
Dealer Website  
         

Business Hours

Service  
Sales  
Parts  
Body Shop  
         
Contact Information
  Name Email Address Primary
Contact
Web Rpt
Access
Seed on
Comm.
Dealer Principle
Gen. Manager
Gen Sales Mgr
Fixed Ops Dir
Service Mgr
Parts Manager
           

Enrollee Information:

     
Your Name
and Email
         
       

 

 

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