Request Website Access

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To become a registered user, which would enable you to purchase products online, please complete and submit the form below. Once processing is complete you will receive a User ID and password and your manager will receive a letter of confirmation.

Please note, you must be a current customer to become a registered user. If you are not a customer, please click here to download the credit application to begin the process.

Shipments outside of the United States cannot be processed online. International shipments must be processed through an KGPCo Canada representative.

User Information

First Name: *

Middle Initial:

Last Name: *

Title: *

Company: *

KGPCo Canada
Account #:

E-mail: *

Phone: *

Ext:

Fax:

Company Address: *
(Line 1)

Company
Address:
(Line 2)

City: *

State: *

Zip: *

Mother's
Maiden Name: *

User Role: *

In an effort to reach you with relevant communications, please select your current role from the list provided.

Company Information

Manager's Name: *

Manager's Title: *

Manager's Phone: *

Ext:

Manager's Fax: *

Manager's E-mail: *

KGPCo Canada
Representative:

Please specify your e-mail preferences:

Please select your preference for web order acknowledgement:

Acknowledge each order separately via an e-mail.

Acknowledge all orders placed on a day via a single e-mail

No sales order acknowledgements needed.

May we send you promotions or site enhancement information via e-mail?

Yes

Please select the applications you want to access:

YES	NO	APPLICATION
		Catalog
		Catalog-Express Order
		Catalog-Shopping List
		Shopping Cart / Requisition Visible
		Order Status

I understand once processing is complete I will receive a username and password and my manager will receive a letter of confirmation. *

* = required fields.

Product information

Order Information

Business Information

Request Website Access