Exactix Registration Form

After you submit this form, within a day or two you will receive an email with a link to register for Exactix. It is important that you provide us with your OWN EMAIL ADDRESS. Do not provide a general email that others have access to as Exactix links your log in to your email address.

*required information

*First Name
*Last Name
*Company Name
*Address
*City
*State:
*Zip Code
*Phone
- -
Alternate Phone
- -
*E-Mail
*Type E-Mail Again:


Please Click "Submit" Only Once!

Please check your Junk or Spam folder if you do not see the email to register.