CCI Xpress / Acct Request Form




Please complete the information below and click "SUBMIT".
You will be notified by CCI within 2 business days with your log-in and password
If you have questions, please call your Customer Service Rep at CCI 800-323-9355

*required Field
 
*Company Name(legal name as it would appear on credit app) Acct#(if you know - but not required)
 
*First Name *Last Name
 
*Job Title
 
*Email Address
 
*Confirm Email Address
 
*Street Address(Ship to address - Not Billing Address)
 
*City *State *Zip
 
*Phone #
 
*PO #