Registration
Create an account to take advantage of the features and benefits that make shopping faster and easier!

Click to download Credit Card Authorization Form
* Indicates required field
Account Information
Email ID: *
Password: *  
Confirm Password: *
Security Question:
Answer:
Country: *
First Name: *
Last Name: *
Job Title:
Business Information
Company Name: *
Business Phone:
Fax:
Evening Phone:
Web Site:
Business Address
Address 1: *
Address 2:
City: *
State:
Zip:
Shipping Address
 
Address 1:
Address 2:
City: *
State:
Zip:
Require Documentation for Access
1. Business License or Seller's Permit.
2. Two proofs of purchase invoices or purchase receipts from apparel/fashion related vendors.
3. Please note, if you're already a VELZERA.COM customer, all you need to provide is a Invoice number.
Credit Card Authorization Live Form
When you click submit button, the live form will be displayed with digital signature.
Please fill it out, and Save it