Order Status | Fey Promo

Account Sign Up

Note: Required fields are marked with an asterisk (*)

Signup Type

(At least one required)
Order Status
Distributor Info

Contact Information

First Name * *

Last Name * *

Company Name * * *

Account Number

Address * * *

City * *

State * * Zip * * *

Email * * *

Send order acknowledgments to this email address

Phone * * *e.g. 123-456-7890

Fax

Affiliation Information

Note: Affiliation and affiliation number are required:

Affiliation * * # *

Regional Association Member

Yes

Regional Association

Resale Certificate Number

Your request can be processed more quickly if you provide us with your Magna-tel Account Number, Company Name, Phone Number, and Affiliation Number.