Dealer Application

To submit your application to become a Simple Pump Dealer, kindly fill out the form.

We do not accept phone requests.

Requirements for Dealers

Professional well and pump knowledge is required by you or other company employee(s).
Well drillers/installers, plumbers, or preparedness companies.
Retail level only. No wholesale distributors.
We recommend you don’t use Hotmail, msn, outlook, or live.com addresses. These domains sometimes have delivery problems.
A valid business license must be able to be verified to show that the business is legitimate.