eWPTS ID/Password Request for Verizon Build Subscription Enrollment Service

Please complete and submit the eWPTS ID Request form below. Request may take up to 5 days to complete.

I understand this Login ID is the property of Verizon Communications and is issued for my use as an authorized agent of the company   named below. I will not allow anyone to use this ID. Verizon Communications is released from any and all liability resulting from an unauthorized   use of this ID. I also understand this ID will be automatically deleted   if  not used for 180 days.

If your ID is deleted, you will be required to submit a new ID Request Form.

Please direct comments to: ewpts.helpdesk@verizon.com

eWPTS ID/Password Request for Verizon Build Subscription Enrollment Service

User's First Name: *
User's Last Name: *
User's Telephone Number: *	In the form XXX-XXX-XXXX
E-Mail Address: *
Supervisor's Name: *
Supervisor's Telephone Number: *	In the form XXX-XXX-XXXX
Company Name: *	(Your Company Name)
Company Address: *
City: *
State: *
Zip Code: *
AECN / CCNA : *	List all associated AECN / CCNA Values applicable for your Company separated by commas Note: These Codes are either 3 or 4 Alphabetic Characters.
User Signature: *	(Type your name here)
Application Date:*	(MM/DD/YYYY)
	ID/Password Requests may take up to 5 days. You will receive a Verizon Communications email notification with your ID and Password.