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  Member Enrollment
Enroll A New Affiliate
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!

PLEASE NOTE:We are requesting a note added under the email address: Only 1 account can be linked to a single email address. If you think you could have an account currently open, you will need to call customer care or use another email address. If you are having trouble signing up please contact Customer Care at 615-647-0900
Unable to determine the enrolling dealer!! Cannot continue enrollment process!
 
 
Tell Us About Yourself
   
Please Enter Your Information Below
Begin here by entering your name and address, along with you shipping information. All required fields are indicated by
  Referred By
Personal Name ●
 
  Display Name (optional - if different than above)
  Shipping Address
  Address ●
   
  Country ●
  City ●
  State ●
  Zip ●
  Contact Information
  Phone
  Email See Note Above ●
  Birthdate
  Identification
  SSN ●
 
 
 
 
     
Affiliate Starter Kit
 
Enrolling As An Affiliate
Add your Affiliate Starter Kit here. You will have the option to add additional products to your order in the next section.

Note: RemeVerse offers free shipping on orders over $50

  Product
 
Select a product in the list above. A description and image of the product will then appear in this area.
 
 
 
     
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
     
Set Up Your Replicated Website
 
Select your website name and password
A replicated website is a very important part of your business that allows you to offer an online shopping experience to your customers. One year of your website and back office is included in today's enrollment, and you will not be charged a separate web fee.
Choose a name for your website that is easy to remember. Your 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.remeverse.com/YOURWEBSITENAMEHERE
 
Website Name
   
Enter A Password For Your Web Office
Password
Confirm
   
 
     
Complete Your Order
 
Final Confirmation
You are almost there! By clicking on the button below, your order will be processed and your enrollment will be complete.

Be sure to remember your password! Look for an email confirmation shortly with details of your order.

 
Terms And Conditions
Please click on the Download link below and read the terms and conditions 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.
Click Here To View Terms and Conditions