New user form

In an effort to provide our customers with the best possible service and prevent unauthorized users from accessing this part of our website the following procedure is in place: After you submit your information below, we will review it and either activate your account or contact you for any further information we may require. This process does not take long during normal business hours (8:30a – 5:00p M-F, PST.) Once we have activated your account we will send you a notification email. You will only need to complete this process when you first sign up.

Prices for items listed on this website are for U.S. customers only. For international orders contact your nearest Costech distributor on our contacts page.

Personal info

first name *
last name *
e-mail address *
confirm e-mail *
password *
confirm password *

Billing Address

company *
street 1 *
street 2
street 3
street 4
city *
state *
zip *
country
phone 1 *
phone 2
fax
contact name
Note - All * items required