Create BPAT Account

Account Access & Security
* Please fill in all fields that are marked as required.
User ID
Email Address: *
Verify Email Address: *
 Email a PDF Copy of each Backflow Test Submitted to this email address
Password: *
Password must be 8-12 characters in length and contain:
  • at least 1 uppercase letter
  • at least 1 lowercase letter
  • at least 1 number
  • at least 1 special character !@#$%^&*/\
    		•
    Verify Password: *
    Cell Number: *
    If you have forgotten your password, a one time use security access code can be sent to your cell phone to access your account.

    Account Contact Information
     
    Company Name: *
    Contact Name: *
    Address: *
    City: *
    State: *
    Zip Code: *
    Work Number:
    Fax Number:
    Website URL: Example: www.mywebsite.com
    Default State:
     Do not show this account in registered BPAT listings

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