ServiceLive [Provider Registration]

Sign up for a provider account so you can accept work and provide service for members of the ServiceLive community. Enter your primary contact information and we'll email you a temporary password that you can use to build your profile on our secure server.

An asterix (*) indicates a required field

Business Information

The fields below give you an opportunity to tell buyers a little more about your business. Your written description will be included as part of your public profile

An asterix (*) indicates a required field

Legal Business Name*	Doing Business As (DBA)
Main Business Phone * - -	Ext.
Business Fax - -
Primary Industry *	Please describe your Industry *
Website Address

Business Address

Street Name *

Apt. #

City *

State

ZIP *

Mailing Address

The mailing address is the same as the business address.

Street Name*

Apt. #

City*

State*

ZIP*

Primary Contact Information - Administrator

By opening this account, you become the ServiceLive administrator for your company. You�ll be the primary contact for all communications with ServiceLive and you will be authorized to enroll additional service providers and support staff for your provider firm.

Role within Company *	Job Title
Legal First Name *	Legal Middle Name
Legal Last Name *	Suffix (Jr., II, etc.)
E-mail Address *	Confirm E-mail Address *
Alternate E-mail Address	Confirm Alternate E-mail Address
User Name * (User name must be 8 characters or more)
Will you perform service calls in the marketplace? Yes No
How did you hear about ServiceLive? *	Referral Code SL-
	Enter all letters, numbers or special characters as shown.

Please enter the Zip Code of the location where work will be done.

Register As A Service Provider