Registration

Registration

Please fill out the form below to register as a customer on our website. Once we have reviewed your registration, and approve it, you will be given access to our internal pricing and be able to place orders.

RM_Stats

Contact First Name^*

Contact Last Name^*

Email^*

Store/Company Name^*

Trading As

If you operate as a number company or under a different name, please enter it here.

Company Phone # (ex. 204-123-4567)^*

Company Fax #

PST/RST #

Treaty #

Billing Info

First Name ^*

Last Name ^*

Company

Street Address 1 ^*

Street Address 2

City ^*

Province/State ^*

Country ^*

Postal/Zip Code ^*

Email Address ^*

Shipping Info

First Name ^*

Last Name ^*

Company

Street Address 1 ^*

Street Address 2

City ^*

Province/State ^*

Country ^*

Postal/Zip Code ^*

Username^*

Only letters and numbers are allowed in this field.

Password^*

Password must be at least 7 characters long.

Enter password again^*

Password must be at least 7 characters long.

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