Account View Tutorial Register > Step 1 Company Info Contact Information * indicates required field First Name* Middle Initial Last Name* Telephone* Fax Email Address* Alt. Email Address† † Provide an Alt. Email Address if you want someone else to receive daily Order Status Reports by email. If no Alt. Email Address is provided, daily email reports will be sent to your main Email Address. Company Information * indicates required field Company* Practice/Business Type* Optical Chain (10 locations or more)Optometric Group Practice (multiple locations)Single Optical Store (Optician)Multiple Optical Stores (2-9 locations)Single Optometric PracticeOphthalmology Group Practice (multiple locations)Single Ophthalmology PracticeWholesale Lab (with surfacing)Other (please describe) or Sales Rep Referring Code Carlos Rosario, FL-PRAshley Wahl, NEXT-AWDave Eichelberger, NEXT-DEJoey Horn, NEXT-JHLuke Helsel, NEXT-LHLexi Mann, NEXT-LMMadison Small, NEXT-MSSue Creek, NEXT-SC Business License Website Number of Shipping Locations* 12345678910111213141516171819202122232425
