New Customers Customers If you are a new customer, please fill out the new customer form below. If you would like your account to be set up on Electronic Funds Transfer (EFT) for your purchases, please visit the Fintech Enrollment Page. New Customer Form Leave this field blank Company Your company name Contact Name Your first and last names Phone Please enter a valid phone number Email example@example.com Shipping Address City State/Province/Region Zip/Postal Code Country Choose United States Canada Billing Address City State/Province/Region Zip/Postal Code Country Choose United States Canada State License Number State License Expiration Date Upload Copy of Resale License (optional) (optional) Browse Files Uploading… (0%) Browse A file with this name has already been uploaded. Oops. This file type isn’t allowed. This file size is too big. Submit
