Employee Enrollment - Step 1
Please follow these instructions to complete your enrollment process:
Please fill out all sections of this enrollment page, starting at the top and working down.
You MUST provide a physical street address as we cannot accept P.O. Box addresses.
Please register only one time and list only ONE Store location. Multiple registrations will delay your approval!
Click "FINISH" to view the confirmation page - Please follow the instructions on the confirmation page carefully.
If you click CANCEL your enrollment information will not be saved.
If you have trouble registering or have questions about the registration/confirmation process, please contact via email at
support@valuesme.com
.
You must have Adobe Acrobat Reader intalled on your computer to finish the enrollment process. Click
here
to download a free version of Adobe Acrobat Reader.
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Employee #
Employee Number is a required field.
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First Name
First Name is a required field.
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Last Name
Last Name is a required field.
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Class
:
Select One
Employee
N/A
*
Country:
United States
Canada
New Zealand
Australia
*
Address 1
Address 1 is a required field.
Address 2
*
City
City is a required field.
*
State/Province
ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
DISTRICT OF COLUMBIA
FLORIDA
GEORGIA
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
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
RHODE ISLAND
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
VERMONT
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING
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Postal Code
Zip is a required field.
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County
*
Phone
Phone is a required field.
Mobile Phone
*
Email
Email is a required field.
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Confirm Email
Confirm Email is a required field.
Email and Confirm Email must match.
*
Username
Username is a required field.
*
Password
Case Sensitive
Password is a required field.
*
Confirm Password
Confirm Password is a required field.
Password and Confirm Password must match.
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