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 Please fill in the form below. Once we have
 received your request, we will email you your login information.

 Account Request

 Store #:
 First Name:
 *Login Name:

 Address:
 City:
 Postal Code:
 Store Name:
 Last Name:
 Email Address:

 Address 2:
 Province:

 

Note: If this account request is for a staff member, a Dealer Permission form is required. If your store has another account, save time by downloading the form off HomeXtra and fax it back to us right away! Otherwise, we will fax the form to your store once we have received the new account request.

To access the Dealer Permission form on HomeXtra, go into the Library and type HXPF into the keyword field of the search tool and click submit.

 * - A password for your account will be automatically generated.
 You can choose to change the password later.