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Transmission Supplier Registration Form Please fill out all required fields with your correct information. You can submit any additional information about your registration in the Comments section below. Please make sure to enter your correct email address, thanks. * Required field Salvage Yard! Grow Your Parts Business! Register Now! * User ID (up to 10 characters) * Last Name * First Name * Password (up to 10 characters) * Repeat Password * Industry Select One ... Association Auction Pool Auto Parts Company Auto Recycler Body Shop Car Repair Crushing Services Claim Service Dismantlers Fleet Company Hobbyist Importer/Exporter Insurance Adjuster Insurance Company Mechanic Online Auction Salvage Yard Shipping Company Software Services Titling Company Towing Service Used Car Dealership Other(Please explain if 'Other') * Company Position * Address * City * State * Zipcode * Country * Phone  Fax * Email * Are you a Licensed Dealer? Yes NoLicense # Web Site Name How Did You Hear About us? Select One ... Advertisement AltaVista Excite Goto.com Friend Link/Banner Mailer Lycos Newspaper Other YahooIf link/banner, what site?  Referred By Additional Comments   Grow Your Business * Please fill out the optional questionnaire shown below to help us better assist you. Do you have a salvage yard?  Yes No If so, what size is your yard/lot?  Select One ... 1-5 Acres 5-10 Acres 10-20 Acres 20-50 Acres > 50 Acres How many employees do you have?  Select One ... 1 - 5 Employees 5 - 10 Employees 10-20 Employees > 20 Employees If applicable, how many cars do you sell per month?   Select One ... 1 - 50 50 - 100 100 - 300 300 - 500 500 - 1000 > 1,000 If applicable, how many cars do you buy per year?  Select One ... 1 - 50 50 - 100 100 - 300 300 - 500 500 - 1000 > 1,000 Are you interested in listing cars on our site?   Yes No Do you have towing capabilities?  Yes No Are you interested in hearing how we can bring you more business in towing and/or storage?  Yes No Are you interested in advertising on our site?  Yes No How often do you go to live auctions? Select One ... Never Once a Month Twice a Month Once a Week How much time do you spend at an auction per day? Select One ... None 1-2 Hours 3-4 Hours 5-6 Hours 7-8 Hours > 8 Hours Would you use an online auction to bid and buy cars? Yes No How many computers does your business have?  Select One ... None 1-3 Computers 4-10 Computers > 10 Computers Do you have access to the Internet on a regular basis?  Yes No Are you interested in listing parts for sale online? Yes No How many parts do you buy/sell per month? Select One ... None 1 - 100 100 - 300 300 - 500 500 - 1000 > 1,000 Does your business have a web site? Yes No If no, are you interested to hear how we can help you build one?   Yes No

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