Merchant Signup Form

For a hard copy of this Agreement Click Here
* = Required fields must be filled in.
Please complete the following application to be considered by eMembersOnly, Inc. as a preferred Merchant.
Associate Name or ID# who referred you:
Category (To Select Multiple Categories Hold The Ctrl key and Click on the option)
* 		Sub Category (To Select Multiple Sub Categories Hold The Ctrl key and Click on the option)
*
  Company Information
Company Name: * Years In Business:
Registered Company Name:
(Only add this if your company name is different from your registered name)
  Discounts Available For EMO members
Discount Given In Dollar Amount1: $ Discount Given In Percentage1: %
Discount Service Type1:
Discount Given In Dollar Amount2: $ Discount Given In Percentage2: %
Discount Service Type2:
Discount Given In Dollar Amount3: $ Discount Given In Percentage3: %
Discount Service Type3:
Discount Given In Dollar Amount4: $ Discount Given In Percentage4: %
Discount Service Type4:
Discount Given In Dollar Amount5: $ Discount Given In Percentage1: %
Discount Service Type5:

Merchant agrees not to raise their normal price before applying the discount available to EMO members.The discount to EMO members will be provided by Merchant upon the member showing the Merchant their EMO membership card or if the transaction is electronic by providing their EMO membership number to the Merchant electronically. Merchant agrees to verify that the card has not past its expiration date.
  Marketing Fee Information

Merchant agrees to pay EMO a fee for marketing to and referring its members to Merchant. Should the Merchant agree to pay EMO a fee, the fee will be percent of the sales price of the goods or service or $ per sale.

Merchant agrees to pay EMO a fee for marketing to and referring its members to Merchant. Should the Merchant agree to pay EMO a fee, the fee will be percent of the sales price of the goods or service or $ per sale.

Merchant agrees to pay EMO a fee for marketing to and referring its members to Merchant. Should the Merchant agree to pay EMO a fee, the fee will be percent of the sales price of the goods or service or $ per sale.

Merchant agrees to pay EMO a fee for marketing to and referring its members to Merchant. Should the Merchant agree to pay EMO a fee, the fee will be percent of the sales price of the goods or service or $ per sale.

Merchant agrees to pay EMO a fee for marketing to and referring its members to Merchant. Should the Merchant agree to pay EMO a fee, the fee will be percent of the sales price of the goods or service or $ per sale.

This fee will be paid within 30 days of Merchant receiving payment from EMO member and will be paid by check mailed to 10942 Grant Road Suite #117, Houston, TX 77070. Merchant agrees to maintain careful record of any transactions with EMO members and will make these records available to EMO within five days of written request.
  Address Information
Physical Address: * City: (Automatic) State: (Automatic)
Country: Zip Code: *
 (Mailing Address same as primary)
Mailing Address: City: (Automatic) State: (Automatic)
Country: Zip Code:
  Profile Information
First Name: * MI: Last Name: *
Company Title: *
Phone: *  Ext:  (Numbers Only)
Fax:  
Hours of operation:
Email Address: *
Business Website:
Brief Description:
500 Characters left.
Credit Cards Accepted: Visa Credit Card Master Card Credit Card Amex Credit Card Discover Credit Card
  Merchant Information
eMembersOnly ID:
Preferred Password: *
Confirm Password:  (Your password will be case sensitive)
  References Information
1) Company Name: Contact Name:
  Mailing Address: City: (Automatic) State: (Automatic) Zip Code:
  Phone: Email:
2) Company Name: Contact Name:
  Mailing Address: City: (Automatic) State: (Automatic) Zip Code:
  Phone: Email:
3) Company Name: Contact Name:
  Mailing Address: City: (Automatic) State: (Automatic) Zip Code:
  Phone: Email:

PROMOTION OF MERCHANT TO EMO MEMBERS
Upon a Merchant being accepted as an EMO preferred Merchant, EMO will notify its membership of the Merchant’s status as a preferred Merchant, the discount offered, the address and/or contact information of the Merchant.  This notification may include posting of the Merchant information on the EMO’s website and by EMO directly communicating to its members by email, written information distributed at meetings, and other forms of communication.  Merchant when applicable will supply EMO Merchant’s logo and/or internet links so that EMO may add logo and/or link to EMO’s websites. Merchant may post a sign or decal that is approved by EMO notifying the public and EMO of its status as an EMO preferred Merchant.

DURATION OF THIS AGREEMENT
This agreement will remain in effect until either EMO or Merchant provides the other of written notice that they wish to terminate this agreement.  Either party may terminate this agreement with or without cause.  Any transactions in process will continue to receive the discount granted under this agreement.  Any marketing and/or referrals fee owed by Merchant on ongoing or pending transactions of Merchant with EMO’s members will be owed and paid to EMO by Merchant as though this agreement had not been terminated.

GENERAL PROVISIONS
RELATIONSHIP OF THE PARTIES: The parties are independent contractors and nothing in this agreement shall make them joint venturers, partners, employees, agents or other representatives of the other parties.  Neither party shall make any representation that suggest otherwise.

GOVERNING LAW: This agreement and performance under it will be interpreted, construed, and enforced in all respects in accordance with the laws of the State of Texas.  Merchant hereby consents to personal jurisdiction of and venue in the states and federal courts located in Harris County, Texas and agrees not to commence or prosecute any such action, claim or proceeding other than such courts.

NON-EXCLUSIVITY: This agreement does not confer on either party any rights that are exclusive.  Merchant is free to enter into agreements with other discount or membership programs which are offered by other organizations and EMO is free to enter into agreements with other Merchants who may or may not be soliciting the same customers and/or clients as Merchants.

SEVERABILITY AND HEADINGS:  If any provision of this agreement is held to be invalid or unenforceable for any reason, the remaining provisions will continue in full force without being impaired or invalidated in any way.  The parties agree to replace any invalid provision with a valid provision, which most closely approximates the intent and economic effect of the invalid provision.  Headings are used for convenience of reference only and in no way define, limit, construe or describe the scope or extent of any section, or in any way effect this agreement.

NOTICES: All notices to Merchant shall be sent by mail or electronic mail provided in the Merchant Application. All notices to EMO shall be in writing and sent to 10942 Grant Road Suite #117, Houston, TX 77070.  Should either party change address for notices they will inform other party in writing within 10 days of changing address.

EFFECTIVE DATE: This agreement becomes effective upon the date that an EMO corporate officer signs this agreement below.  EMO will sign this agreement following the review and approval of the Merchant’s application and the Merchant signing this agreement below.

ENTIRE AGREEMENT:  This agreement sets forth the entire understanding and the agreement of the Parties, and supersedes any and all prior or contemporaneous oral or written agreements or understandings between the parties, as to the subject matter of this agreement.
*By executing this agreement, Merchant acknowledges and agrees that it has reviewed and understands this agreement and agrees to be legally bound by all of its terms and conditions.