New Contractor Application

Thank you for wanting to become an Air-Care partner! We’re excited to work with you and help you succeed in your new business.

After you fill out this form, you’ll get two emails:

The first email will have a link to set up your account. Click on it to activate your account.
Once you’ve activated your account, you’ll get a second email with a link to log in.

If you have any problems with your application, please email cs@air-care.com or call (702) 454-5515. We’re here to help!
PLEASE NOTE: This is for US based contractors only.

"*" indicates required fields

Name*

First Last

Email*

Enter Email Confirm Email

Username*

Password*

Enter Password Confirm Password

Business Information

Business Name (DBA)*

Company Phone*

Business Website URL*

Business Address*

Street Address Address Line 2 City State ZIP Code

United States Federal EIN Number*

Enter EIN in this format: "00-0000000" You must enter a valid EIN number or your application will not be accepted.

How Did You Hear About Air-Care?

Other

Phone

This field is for validation purposes and should be left unchanged.

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