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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 
 If 'Others', Please type in your Job Title
Personal & Login Details
Title *
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 * 
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
if 'Other', Please Specify
Newsletter Subscription

To subscribe, please select this option box:

Email Type
Use the email address  as specified in "Login Details" :
Email Address
Tell me about
Software Update
New Products
Special Offers
New Devices

Tel: +44 (0)1942 841975 Fax: +44 (0)1942 844181 email: info@equinox-tech.com
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