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  Enroll A Customer
Enroll A New Customer
Build your business! You may enroll new customers here and place their initial order (if required). If you are setting up an autoship, with or without an order, you will be required to enter payment information. If no autoship is selected and no balance is due, you will not be required to enter payment information.
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Tell Us About Yourself
   
Please Enter Your Personal Information
Begin your enrollment here by entering your name and address, along with you shipping information. All required fields are indicated by ●
  Referred By
Name ●
 
  Company Name
  Shipping Address
  Address ●
   
  Country ●
  City ●
  State ●
  Zip ●
  Contact Information
  Phone ●
  Email ●
  Birthdate ●
 
 
 
 
 
 
     
Select A Customer Type
 
Signing up as a VIP Customer
You have chosen to sign up as a customer in our program. This form is used to sign up customers that will receive special benefits.

If you would prefer to simply be a retail customer, then you may sign up through the shopping cart.
 
  Product
   
 
 
     
(Optional) Easy-Ship Setup
 
Choose which products you'd like to set up for Easy-Ship. Your recurring order will be setup to renew 30 days from the day you place your initial order.
Never want to run out of your favorite EMRIS Products? Setup a convenient Easy-Ship to fit your schedule and your tastes. Cancel anytime!
 
Monthly Easy Ship
Set up your Monthly Easy Ship order now!
 
     
Enter Payment Information
 
Select A Payment Method
Enter your payment method below. Once this form is completed, you will be on your way to building a new and exciting business!
 
Order Totals
Product Sub-Total $ 0.00
Discount Applied $ 0.00
Shipping and Handling $ 0.00
Country Specific Fees $ 0.00
Sales Tax $ 0.00
Gift Certificates Applied $ 0.00
Total Amount Due $ 0.00
 
Select A Shipment Method
Shipping Method
 
Have a Coupon? Apply it here
Enter Coupon Code
   
 
Apply Your Gift Certificates Here
Search by Serial Number  
 
 
Payment Method
 
Billing Address (must match credit card)
 
Name
 
Address
 
Country
City
State
Zip
     
Complete Your Order
 
Final Confirmation
You are almost done! By clicking on the button below, your order will be processed and your enrollment will be completed.  You will receive an email confirmation shortly with details of your order.
 
Enter An Account Password
Password
Confirm