Web Order Entry Sign Up Request type*Request TypeSign up for Web Order Entry & MobileSales (new user)Sign up for Web Order Entry (new user)Add MobileSales to an existing Web Order Entry accountHVAC Account Number*Customer/Account Name*City*State*DEMDNYOHPAVAWVName of User* First Last Email to Use for Web Order Entry* Requested Permissions for the UserSuperuser Authorization (ability to add/modify users)*YesNoAbility to View Accounts Receivable Information*YesNoAbility to View Pricing on*Web Order Entry OnlyWeb Order Entry & HVAC MobileSalesSend Login Details to:*User Identified in this formSomeone elseEmail to Send Login Details to* Terms & Conditions Web Order Entry accounts are for active customers of HVAC Distributors, Inc., dba HVAC Distributors Group only ("HVAC Distributors"). HVAC Distributors reserves the right to discontinue web order access for customers that do not actively purchase products from HVAC Distributors over a calendar year. Web Order Entry accounts require a SuperUser who administers the account to provide employees at the company with access to web order entry at the access level determined by the company. HVAC Distributors is not responsible for monitoring employment status or access level of Web Order Entry users. It is the company's responsibility to notify HVAC Distributors if a SuperUser leaves employment of the company so the SuperUser's access to corporate Web Order Entry accounts can be removed and a new SuperUser can be designated for the company. Any adjustments to the terms and conditions of HVAC Distributors' Web Order Entry service will be made following a thirty (30) day notice of change of terms to all active customers via current address on record with HVAC Distributors. By signing or submitting this form, you acknowledge that you have the authority to commit your company to this relationship with HVAC Distributors and that you understand the terms and conditions outlined above. Confirm* I acknowledge that I have read and understand the terms and conditions related to Web Order Entry service. CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.