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Individual $54.00 (Annual renewal $25.00 - see Agreement of Distributorship
below)) |
| Name: |
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| SIN or SSN: |
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| Address: |
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| City: |
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| State/Province: |
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PC/Zip
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| Country: |
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| Email: |
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| Day Phone: |
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| Evening Phone: |
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| Credit Card
Number: |
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| Payment Method: |
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| Expiration
Date : |
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Payment
information
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Reply to you by:
phone
e-mail
none |
| Best
time to call:
day
evening
none |
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I will call Wachters' with payment method. |
|
I agree to be bound
by the terms and conditions of the Agreement
of Distributorship:
Yes
No
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Your upline Executive Distributors
are:
|
Comments
or Questions?
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Wachters'
may also be reached by calling
1-800-682-7100
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