Customer Registration Form

Thank you for registering with Equinox !
Please fill in your Personal / Company details in the form below and then click [Register] at the bottom of the form to complete the registration. You can change any of your details at any time after you have registered by simply logging back in again.

Please select your customer type	I am Private Customer I am registering on behalf of a Company *
Company Name	*
Job Title/Position	(Please Select)Accounts ContactDesign EngineerDevelopment EngineerDevelopment ManagerDistribution ManagerEngineering ManagerField Application Engineer (FAE)Hardware EngineerLecturerNetwork AdministratorProduction EngineerProject EngineerPurchasing Contact Purchasing ManagerResearch AssistantSenior Project EngineerSoftware EngineerStudentTechnicianTest EngineerOther  If 'Others', Please type in your Job Title
Personal & Login Details
Title	(Please Select)Dr.Miss.MrMrs.Ms *
First Name	*
Last Name	*
Please fill in your email address and a memorable password below. This information will be used to setup your account at Equinox.
Email Address	*
Password	*
Confirm Password	*
Your password must contain at least 7 characters, of which a minimum of 3 should be digits (0-9) and 4 should be characters (A-Z).
Please fill in your address details.
Address	*
City/Town	*
County/State
Country	(Please Select)AfgahnistanAlbaniaAlgeriaAmerica SamoaAndorraAngolaAnguillaAntigua and BarbadosArgentinaArmenia, Republic ofArubaAustraliaAustriaAzerbajan (Republic of)BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HezegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCayman IslandsCentral African RepublicChadChannel IslandsChileChinaColombiaComoros IslandsCongoCongo, Dem. Rep. ofCook IslandsCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjlboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFiji IslandsFinlandFranceFrench GuyanaFrench PolynesiaGambiaGambonGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIreland (Northern)Ireland (Republic of Ireland)IsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueNamibiaNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNorth KoreaNorwayOmanPakistanPalauPalestine AuthorityPanamaPapau - New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussian FederationRwandaSaipanSamoa, WestSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSingaporeSlovakiaSloveniaSouth AfricaSouth KoreaSpainSri LankaSt. Kitts & NevisSt. LuciaSt. VincentSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurks & Caicos IslandsUgandaUkraineUnited Arab Emirates (UAE)United KingdomUnited States of AmericaUzbekistanVanuatuVenezuelaVietnamWallis & FutunaYemenZambiaZimbabweOther*
Post Code/Zip Code
Telephone	* Please Enter the full international dialling code with your number. e.g. +44 1204 5290000
Fax
Mobile
Operating System
Operating System	(Please Select) DOS Windows 3.1 Windows 95 Windows 98 Windows Me Windows 2000 Windows XP Windows NT4 Linux Unix Other if 'Other', Please Specify
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