U.S. Customer Application Form
Thank you for your interest in Restek. To place an order with us, an account for your company must be established in advance. To set up an account, please complete this electronic application. Payments for new accounts will be established as credit card only, unless you also apply for credit terms. If your company wishes to establish credit, you will have the option to do so after submitting this form.
If you have a question about your application or need assistance with an urgent request, please contact Restek Customer Service at email@example.com or call 1-800-356-1688, extension 3.
Fields marked with an asterisk (*) are required.