Client accounts

This form lets you sign-up as a customer of Médiatech. Once your account has been validated by us, you will receive a user name and password by e-mail and you will be able to access our online ordering system.

First name
Last name
Company Name
E-mail
Phone Number

Company Type
Fax Number
Address
Years in business
Credit Limit Requested
Responsible for Payable Accounts
GST Number
TVQ Number
References
Supplier
Phone Number
Fax Number
Supplier
Phone Number
Fax Number
Supplier
Phone Number
Fax Number

Médiatech 3361 avenue de la gare, Suite 120t, Mascouche, Québec, Canada J7K 3C1
T: 450 622-6066    Fax: 450 622-4537    Toll-free: 1 866 622-6066    info@mediatech.ca

Contact us

Company name

Your name

Telephone

Email

Message

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