Insurance Company Registration Form

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  Requester's Registration Form Instructions
* = Required  
* First Name
* Last Name
Company
* Street Address 1
Street Address 2
* City
* State / Province
* Zip Code
Country
* Office Phone Extension
Fax
Alternate Phone
* E-mail Address
Please add me to the private mailing list for news and updates
User Information Select a User ID and password. You will need these each time you place a bid, setup and/or manage auctions or contact requesters and bidders via e-mail. (20 chars. Max, 4 chars. Min, case does not matter).
* User ID
* Password
* Confirm (Confirm you password by entering it a second time)
* What marine business
do you represent?
If Other?
(Let us know what other marine business you represent so we can possibly add a category for you.)
How did you hear about us?
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site and our industry. 		We offer all our registered users a monthly e-mail newsletter to keep you up to date on MarineBidExchange.com and industry news. Check the box below if you approve.

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Agreement & Submission I agree that by submitting this registration that a) the information provided by me is complete and accurate to the best of my knowledge, and that b) purposefully providing false information in order to wrongly participate in an auction could be considered criminal activity, and c) should the situation arise, I hereby authorize the site to release relevant information to involved parties for settlement of dispute. I have read, understand and agree with the Conditions of Use posted on this website and I will participate in RFPs and Auctions according to those conditions of use.

Please verify the above information is correct before submitting!

   
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