B2B Access Request Form

Please complete this form to request access to the B2B portal. Once submitted, your request will be reviewed, and login credentials (username and password) will be provided upon approval. Email US-MegadyneJasonB2B_USER@ammega.com if you need assistance.

Company(Required)

Customer Account Number(Required)

Email US-MegadyneJasonB2B_USER@ammega.com if you need assistance with your account number. Please include your company name in the email.

Branch Number

For companies with multiple branches, please list all branches you order for

Address(Required)

No PO Boxes If you order for multiple branches, please enter company's primary address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Registrant Name(Required)

First Last

Registrant Email(Required)

Password(Required)

Minimum of 6 characters

How did you learn about the B2B Portal?

CAPTCHA

Name

This field is for validation purposes and should be left unchanged.