EPAConline New User Registration Form
Lansing Community College Vendor Registration
Use of EPAConline requires a unique username and password. Please provide us with the following information and then choose a unique username and password which will be used to customize the EPAConline site for you and your company.

Personal Information
First Name:
(required)
Middle Initial:
Last Name:
 (required)
E-mail:
 (required) must be a valid email address
NOTE: your e-mail is required for important EPAConline features to work. Also a confirmation of your registration will be sent to this e-mail address. Please double check to make sure it is correct.
Company Information
The company information entered below will be used when creating your free directory listing as well as generating a cover page for any RFQ that you wish to bid on. Therefore it is important to enter the following information in the same way you wish it to appear in the directory lisitng as well as on any bid you wish to make.
Company Name
 (required)
Your Title in this Company
Company Address
(required)
City
 (required)
State
 (required)
Zip
 (required)
County
Country (e.g. United States)
Office Phone Number
(eg (313) 961-0000 )
 (required)
Fax Number:
Do you want to list your company in the EPAConline Supplier Marketplace Directory (Paid Members Only)
 No Yes
What type of business is the company (Choose one from the list) ?
What is the primary product or service of the company ?
Year company established (i.e. 1991)
Type of Organization
Please estimate how many employees work at your location ?
Is this a woman owned business ?
 No Yes
Is this company unionized?
 No Yes
NAICS/SIC:
Other NAICS/SIC CODES (separate multiple values with a semi-colon ";")

Minority Certification/Registration Agency
City Of Detroit
 DOT
Sheltered Market Program
County Of Wayne
 DBE Program
M/WBE Program
SBE
State Of Michigan
 DOT
M/WBE Program
Other
 Small Business Administration
Smart DBE Program
Majority Business Initiatives
Specify Another Agency:
No Certification
Minority Business Classification
African American
Hispanic American
Native American or Alaskan
Asian American
None
Sales Info
Annual Sales Range of your company $1 Million or Less
$1 Million to $3 Million
$3 Million to $5 Million
$5 Million or More
Identify three major customers:
Customer:Contact:Phone Number:
Username and Password
Finally, choose a username and password that you will use every time you access the EPAConline site. For your username we suggest using some combination of your First Name, Middle Initial, and Last Name (ie "John Q. Public"). You may only use letters, numbers and periods in your username. Special characters such as commas,spaces(Blanks) and "@" are not valid for the username. The username and password are case-sensitive. Keep your password private in a secured location.
Username:
 (required)
Password (at least 3 characters long):
(required)
Type Password Again To Verify:
 (required again)
To help us verify your identity in case you lose your username and/or password in the future please enter a question that only you know the answer to below:
Question: (e.g. What is your favorite movie?)
Answer: (e.g. Casablanca)
Choose your level of service.
EPAC Level:
Public
Continue Registration
Please double check to make sure you have filled in each of the required fields above before pushing the Continue Register button. Otherwise you may have to come back and fill out this registration form again. Thank you.

Submission of this EPAConline Account Registration means you agree to the EPAConline Terms of Service shown below. We highly recommend you read the Terms of Service before proceeding. If you don't agree with the Terms of Service click here to Cancel Registration and return to EPAConline's homepage.