Activate Account

Fisher Rebates & Rewards Login Creation Form

Creating your login for Fisher Rebates & Rewards is easy! Simply fill out the form below and click "Submit Form!" when you are finished. In addition to creating a login, the form can be used to update information, change a password, or add Federated Suppliers.

Your account will be activated in 3-5 business days. You will recieve a welcome letter via email with your username and password.

My Company and User Information

Company Name: (Company Legal Name)

DBA Name: (Doing business as name)

Physical Address:

Mailing Address: (PO Box#, Warehouse #, etc.)

City:

State:

ZipCode:

ATD Account No: (Must be 6-digits and correct for activation; example: 561211)

Your Name: (firstname lastname)

Phone No: Ext:

E-Mail Address:

UserID/Password: (UserID must be unique)

Password Recover:

Supplier Information

Parts Store Name:

Account No.:

Parts Store Name:

Account No.:

Parts Store Name:

Account No.:

Form Status - All OK!

I agree to the usage terms.
Review Usage Terms...

NOTE: All information provided will be kept private and used specifically for research purposes. All bold data entry fields are mandatory and must be filled-out. Please allow 3 to 5 business days for your login account to be activated. You must agree to the usage terms and check the appropriate box above to obtain access to the website.