You will need to fill out this form prior to submitting the main registration for an online account. Once you submit the form below, we will use the information submitted to send you an e-mail containing an account-specific Access Code. This Access Code is required to complete the main registration form.

Your Name

Company Name



State (US) or Province (CA)

Zip Code


Fax (optional)

Your Email

Message (optional)

All fields are required unless marked.

Please Note: Valley Cartage will e-mail you a response with an Access Code once your request is processed.  The e-mail will contain specific instructions for completing the main registration form.