close
Close
Header
Processing Your Enrollment. Please Wait...
Member Enrollment
Enroll A New Member
Build your business! You may enroll new members here by entering their personal information and placing their enrollment order. By continuing to build your business, you are ensuring your success as you climb your way to the top! Enrolling is simple and easy. Just fill out this form and we will take care of the rest!
Unable to determine the enrolling dealer!! Cannot continue enrollment process!
Tell Us About Yourself
ENGLISH
SPANISH
[Select Language]
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
●
Ghana
Micronesia, Federated States of
Nigeria
Palau
Puerto Rico
Samoa
South Africa
United States
United States Virgin Islands
City
●
State
●
[Select A State]
Alabama
Alaska
American Samoa (see also separate entry under AS)
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam (see also separate entry under GU)
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Not Applicable
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico (see also separate entry under PR)
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
●
Contact Information
Phone
●
Email
●
Birthdate
●
Identification
SSN/EIN/South African ID#
●
Select Your Products
Enrolling as a Brand Ambassador
Select the rank and product you wish to enroll with. Once you select a product, the system will display an image and description of your selection.
Product
[Select A Product]
Basic Starter Pack - 49.00
Business Builder Kit - 199.00
Legacy Builder Kit - 499.00
Legacy Builder Kit #2 - 499.00
Presidential Kit - 999.00
Select a product in the list above. A description and image of the product will then appear in this area.
(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!
[Select an Option]
Synergy by EMRIS 150 mg Natural Flavor - 59.00
Synergy by EMRIS 250 mg Natural Flavor - 79.00
Synergy by EMRIS 150 Lemon Flavor - 59.00
Synergy by EMRIS 250 Lemon Flavor - 79.00
Vida by EMRIS - 59.00
Vitality Plus by EMRIS - 59.00
Synergy 500 Lemon by EMRIS - 119.00
Synergy 250 Lemon and Vitality by EMRIS - 138.00
Synergy 150 Lemon and Vitality by EMRIS - 118.00
Synergy 250 Lemon and Vida by EMRIS - 138.00
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
[Enter Address and Select Product First]
Have a Coupon? Apply it here
Enter Coupon Code
Apply Your Gift Certificates Here
Search by Serial Number
Payment Method
[Select A Payment Method]
Master Card
Visa Card
Billing Address (must match credit card)
Use shipping address
Name
Address
Country
[Select A Country]
Ghana
Micronesia, Federated States of
Nigeria
Palau
Puerto Rico
Samoa
South Africa
United States
United States Virgin Islands
City
State
[Select A State]
Alabama
Alaska
American Samoa (see also separate entry under AS)
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam (see also separate entry under GU)
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Not Applicable
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico (see also separate entry under PR)
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Set up your Replicated Website
Select your website name and password
A Replicating website is an important part of your business. Choose a name that will be easy to remember! Your website name must be unique in our system and must not contain any spaces or special characters. An example of a correct website name is as follows:
http://www.emrisinternational.com/YOURWEBSITENAMEHERE
Website Name
Enter A Password For Your Web Office
Password
Confirm
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.
Policies & Procedures
Please click on the Download link below and read the Policies & Procedures document. Once you understand and agree to the terms outlined in this document, select the 'I Agree to the terms and conditions' checkbox below to continue.
* Charges on your statement will appear as Emris44203746113
Click Here To View Policies & Procedures
I Agree to the Policies & Procedures