Ucom Trading Inc.

New Customer Registration Form

If you already have an account with us, please login at the login page.

General Information (Your Email will be your Login ID)

Customer Group

Default

First Name:

Last Name:

Email:

Email Confirmation:

Password:

Password Confirmation:

Cellphone:

Business Website:

Telephone:

Digits only, no space dash or parenthesis

Fax:

Digits only, no space dash or parenthesis

Business Type:

Company / Invoice Address

Company Name:

HST/GST Number:

HST No Resale Permit Number

Address:

City:

Country:

Post Code:

Province:

Shipping Store Address / Store Location

Store Name & Location:

Mall Name:

Address:

City:

Country:

Post Code:

Province:

Company / Invoice Address

Company Name:

HST/GST Number:

HST No Resale Permit Number

Company Address:

Company City:

Company Country:

Company Post Code:

Company Province:

Shipping Store Address / Store Location

Store Name & Location:

Mall Name:

Address:

City:

Country:

Post Code:

Province:

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