American Purchasing Society

Primary Representative Name *:

Primary Representative Email *: Present or Former Company Name: Industry * Company Division: Primary Representative Title: Primary Representative Title Code: Primary Representative Country *: Primary Representative Address Line 1 *: Primary Representative Address Line 2: Primary Representative City *:

Primary Representative State *:

Primary Representative Zip/Postal Code *: Primary Representative Phone Number *: Primary Representative Fax Number:

Primary Representative Username *: Primary Representative Password *: Confirm Password *:

Secret Question *: Secret Answer *: Confirm Secret Answer *:

The correct membership type and cost have been chosen based on your country selection.
Note that there is a one time setup fee included in this price Membership Type:

Purchasing a company membership provides three user accounts for use on the site. Would you like to purchase more users now? Each user costs an additional $129.00 each. You can always add more later as well. Additional Users:

Would you like to purchase the optional Membership Plaque? IL residents, please add $6.52 tax for a total of $85.52. This will appear automatically in the cart during checkout. Plaque Amount: