Price King New Customer  Registration

Thank you for choosing to shop with Price King Online. Please fill in all the information on this form and then press the 'Submit' button below.

WE DO NOT COLLECT PAYMENT ONLINE!
 Just place your order and check out.    We will contact you before processing your order and discuss payment options,freight Etc.....

If you are an existing PRICE KING customer (and this is your first time here), please fill all the information below, so we can identify you correctly and set up your internet account. We will ship the same as usual!

All items with red Prompts (below) must be filled in.


Are You an existing PRICE KING Customer?
        Yes     No
  Password below will be used for future log-in!
Password:
Confirm Password:
Your E-mail:
Confirm E-mail:

Bill To:		 .
Company name:
Address-1:
Address-2:
City:
For US states use the 2 letter abbreviation
State/Prov:  Postal Code: 
Country:
e.g. 718-555-5555   or   +44-0-20-7245-1116
Phone:
Fax:
First and Last Name:
Your Position:
 
Resale Number:    ( Optional )

    Ship To:
 
If same as 'Bill To' Then skip the rest
Company  Name:
Address-1:
Address-2:
City:
For US states use the 2 letter abbreviation
State/Prov:  Postal Code: 
Country:
e.g. 718-555-5555  or  +44-0-20-7245-1116
Phone:
Fax:
Contact 1st & Last Name:
Contact Position:

    Let Me Know About any Promotions,Sales or Specials You May Have