Registration Request – Total Service Stations

Before completing this form; have you tried to reset your password?

To reset your password; enter your email address here and follow the prompts.

  • Please Note: This Registration form is for Total Service Stations Only.
  • The registration process is manual, and your application will need to be approved, expect up to a 24 hour delay Monday – Friday.

    Name:*

    Surname:*

    Email Address:*

    Business Name:*

    Job Description:*

    Address:*

    Address:

    Suburb:*

    City/Town:*

    Province:*

    Postal Code:*

    Country:*

    Phone:*

    Cell:*

    Fax:

    Website:

    * Required Fields