Registration Form

Please Note: You should write down the password you set below as we do not send passwords with your Registration Welcome Email!

  • Registration Profile Information

    Provide User Information Below:
  • Minimum length of 8 characters.
    The password must have a minimum strength of Medium.
    Strength indicator
  • Required phone number format: (###) ###-####
  • Example: What do you do? (e.g. we manufacture fiberglass sailing yachts, or we manufacturer refrigeration trailers, we are a RV mobile service and repair business) What is your expertise? (e.g. We specialize in fiberglass and making beautiful yachts, we specialize in aluminum clad foam sandwich panels to manufacture the commercial trailers bonded onto a steel trailer, we are a retired couple and we work from our mobile home and we repair onsite waterproofing, plumbing, motor, interior repairs or rebuilds on the go.) Do you have a facility or are you mobile? (e.g. we have a fabrication facility in Clearwater Florida, we have a fabrication facility in the hills of North Carolina, we do not have a fixed facility and work in the summer in Wisconsin and winter in Florida). Write and much and as little as you want, we will use what ever you write to better understand what you need from Fixtech.
    Enter monthly purchase range