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Create a New Account

Please fill the form below in order to open a new account.

Company Name: *		US MASTER DISTRIBUTOR EROSTAR Inc P.O. BOX 44 New Hyde Park New York, 11040 USA
Contact Name: *
Reseller Id (Tax Id): *	Example: 00-0000000
Address:*
City:*
State:*
Zip:*
Country:*	Choose Country United States United Kingdom Argentina Armenia Australia Austria Bahamas Bangladesh Belarus Belgium Belize Bermuda Bolivia Brazil Bulgaria Canada Chile China Colombia Costa Rica Croatia Cyprus Czech Republic Denmark Ecuador Egypt Estonia Finland France Georgia Germany Greece Guatemala Honduras Hong Kong Hungary Iceland India Indonesia Ireland Israel Italy Jamaica Japan Jordan Kenya Korea, Republic of Latvia Liechtenstein Lithuania Luxemborg Malaysia Malta Mexico Moldova, Republic of Morocco Myanmar Namibia Nepal Netherlands New Zealand Nicaragua Nigeria Norway Pakistan Panama Paraguay Peru Philippines Poland Portugal Puerto Rico Romania Russian Federation Singapore Slovakia Slovenia South Africa Spain Sri Lanka Sweden Switzerland Taiwan Thailand Tunisia Turkey Ukraine Uruguay Venezuela Other
E-mail:*
Phone Number: *
Fax Number:
Website Address (URL1):
Website Address (URL2):
Drop Ship Program
Join our Drop Ship Program	Yes No
Other Information
How Long Have You Been In Business:	Just starting 1-3 years 4 years plus
Expected Business Volume Projections:	Pick One Just Starting Out 0$ to $10,000.00 $10,000.00 to $50,000.00 $50,000.00 to $100,000.00 $100,000 and up
Comments:
Validation Code*:	Code:
* Required Fields

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