MONTANA ASSISTIVE TECHNOLOGY PROGRAM (MATP)

Create New Account

You must have a user account before you may checkout equipment. Are you checking out equipment as part of your job? If so, please consider also requesting a Cooperating Agency Agreement from our Agreements and Forms page. (The cooperating agency agreement allows for multiple individuals within an organization to request equipment. This agreement places the liability on the organization instead of the individual.)

Please provide your information to Create a new account. If you are not able create an account online, or you don't have an email address, please contact us.
Fields marked with an asterisk (*) are required.

Desired Username:
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Desired Password:
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(must be 8 characters long or longer)
First Name:
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Last Name:
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Agency (If you are covered under your agency's user agreement with MonTECH):
Phone Number:
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Fax Number:
E-mail Address:
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Physical Mailing Address (No P.O. Boxes) Line 1:
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Physical Mailing Address (No P.O. Boxes) Line 2:
City:
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State Abbreviation:
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Zip Code:
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Secondary contact info or other details:
How did you hear about us?


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