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New Corporate Account Request

If you represent a business, and would like to establish an account with us, complete this form to create your own online account. Once submitted, we will e-mail you your user name along with complete instructions. Alternatively, you may choose to print out this form and fax it along with bank and credit references to +1.289.813.0366.

If you have any questions or would like further assistance, please contact us at +1.888.423.2700.

Company Information

Company Name:*
Contact Name:*
Contact Email:*
Address Line 1:*
Address Line 2:
City:*
State/Province:*
Country: Canada
Zip/Postal Code:*
Phone:*
Fax:
D&B Number:
Credit Req'd:

Bank Information

TechXtend offers a direct credit line to qualified customers. Complete the bank information fields below and we'll set up an account for your organization upon approval. The fields below are optional; you may submit only your company information now and an account representative will fax a credit application to you shortly.
Bank Name:
Account #:
Bank Contact:
Bank Phone:

Trade Information

Please provide the name and address of one of your current suppliers as a credit reference.

Company:
Address Line 1:
Address Line 2:
City:
State/Province:
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Company Address 3330 Ridgeway Drive
Unit 10
Mississauga, ON L5L 5Z9
Company Phone 888.423.2700
Company Email salesasst@techxtend.ca
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