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New supplier form

For more information about becoming a VIA Rail supplier, please click on one of the links below.

Please fill in the form below to be added to our potential supplier list.

You must complete all fields marked with an asterix (*).

First name (main contact) * 
Initial (main contact)    
Last name (main contact) * 
Job Title * 
Phone number * 
E-mail * 
Confirm your E-mail * 
Change your password * 
Confirm your new password * 
 
When logging into your account, you will be asked to provide the above E-mail and password.
 
Company name * 
Address 1 * 
Address 2    
City * 
 
Country *


 Province/State *
Please enter your province or territory.

Postal/Zip Code * 
Phone number * 
Fax number * 
WEB Site URL    

Date of incorporation    
Number of employees    
G.S.T. Registration #    
Q.S.T. Registration #    
Payment Terms    
%    
Days    
Language  * 
Credit CArd Payment    
Q/A Program Name    
Valid Until (Month/Year)    
ex: 01/06    
President name
 Phone number
 E-mail
QA Manager name
 Phone number
 E-mail
VP Marketing
 Phone number
 E-mail
Describe what your company does

 



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