Step 1: Store Contact Info Registration

Business Name (required)

Address (required)

Email (required)

Mobile Number (required)

Step 2: Account Type Info Registration

Account Type (required)
Prepaid AccountACH Account

Rep Owner (please specify) (required)

Confirm Prepaid Master TSP/Platform (required):
LWPVerizonRT2/ATTCricketGenMobileUltra Mobileh2oPayments only to Emida- Payments only

Existing AT&T Prepaid dealer or New? (required)
ExistingNew

If existing, confirm Branch ID:

Welcome/ Training Call (required):
YesNo

Training Call Date and Time:

Onboarding App Signatures Call Date and Time:

Select Welcome Kit Desired (required):
LWP KitVerizon KitCricket KitGenMobileRT2/AT&T KitFreeUp Kith2o KitUltra Mobile KitLyca KitEmida Posters

Additional Notes

Upload Emida App (required):