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First Name^*

Last Name^*

Phone No.

Include area code e.g. 03 or 08

Company Name^*

Do you have an existing credit account with Alfex Laser?^*

Yes
No

If you do not have an existing credit account, payment in full is required for all orders. Alternatively, you can apply for a credit account by emailing accounts@alfexcnc.com.au

Email^*

Please avoid generic email addresses such as info@companyname.com.au

Address

Username^*

We recommend using your email as your username

Password^*

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Do you currently own a laser?

Yes
No

If so, which model/make and how old is it?

What industry do you predominantly service?

Approximate annual spend on engraving materials?

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