Client Registration Form

Please Enter the appropriate information so that we may respond with more information.
** Required Fields are displayed in red. **

	Corporate Email Address (must be company email)
	Re-enter the Corporate Email address

	Existing Customer	No
		Yes
	Company Name
	Plant
	Address1
	Address2
	City
	State
	Zip/Postal Code
	Country
	Phone
	Fax
	First Name
	Last Name

	Customer verification: please chose one of the following	Kawasaki Controller Serial No.
		Kawasaki Robot Serial No.
		Kawasaki Work Order No.
		New Customer (enter NEW in box below)
		Not an existing customer (enter N/A in box below)
	Enter the verification data selected above
	If you have a contact person at KRI, please supply their name (enter N/A if not applicable)
	Comments
	If you'd like to create your own password, enter it here: