Please register by completing the following form. You will be contacted by our consignment specialist who will discuss in detail our consignment program and answer any questions you may have.

First Name	MI	Last Name

Company Name

Company Address	Suite

City	State

Country	Postal Code

Email Address

Tel #	Fax #

Type of Company	Your Job Function/Title
Contract Manufacturer Sub-Assembly Contractor Military Contractor Aerospace Microwafe/RF Government Agencies Telecommunications Distribution Medical Equipment Computer Equipment Consumer Electronics Other	Purchasing Agent Purchasing Manager Materials Manager Surplus Sales Coordinator Director of Purchasing Inventory Control Other