ONLINE ACCOUNT REGISTRATIONNOTE: Online account registration is only available for current customers.Please enable JavaScript in your browser to complete this form.ACCOUNT TYPESORDERING: By authorizing these individuals, you are permitting them to place orders on your behalf. They will also have access to dilution ratios and various spreadsheets to assist in setting up and running Qual Chem chemistry. TECH: By authorizing these individuals, you are permitting them to have access to dilution ratios and various spreadsheets to assist in setting up and running Qual Chem chemistry.Company Name *Your Name *Your Email *Acknowledgement *I authorize the following users to act on our behalf as outlined above.REP INFORep #1 Name *FirstLastRep #1 Email *Rep #1 Desired PasswordRep #1 Account TypeOrderingTechRep #2Rep #2 NameFirstLastRep #2 EmailRep #2 Desired PasswordRep #2 Account TypeOrderingTechRep #3Rep #3 NameFirstLastRep #3 EmailRep #3 Desired PasswordRep #3 Account TypeOrderingTechNameSubmit
