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Dealer Registration

Dealer Sign in

Register as a Dealer Member
If you would like to be a dealer of Eyesonic products please sign up as a dealer on-line by filling out the registration form below. To complete the process you will receive a credit application via email to be filled out. Upon receipt and approval of your credit application, you will become an approved dealer.

If you are an existing dealer of Eyesonic products please sign up as a dealer on-line. Approved dealers will have access to pricing information. Please fill out the registration form below.

All personal information is strictly confidential. Information will not be sold or released to third parties. Upon completion of the form, your information will be reviewed for approval. If approved, your password will be sent to the email address entered. Please make sure the email address is a valid one.
User ID:
Password:
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Are you an existing Eyesonic Dealer? Yes    No
Company Name:
Business Industry Description:
Company Address:
Company City:
Company Province:
Company Postal Code:
Company Telephone Number:
Company Fax Number:
Company Email:
Representative's Name (first, last):
   
Dealer Login Info:  
User ID:
Comments:
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