For Earth FORCE Distributor Enrollment Form

Simply Fill In The Blanks and Click The Submit Button Below
     New Distributor Information
Your FORCE Connection Is
(Who Caused You To Join) *
Please Enter Your Connection's Name & Email Address
(You wouldn't want folks to forget You now, would you?)
Country *
State *
Company
First Name *
Last Name *
SSN / EIN *
   xxx-xx-xxxx
Birth Date (mo/day/year) *
Preferred User Name#1 *  Used to Sign In to Your FORCE Website Back Office
This will become part of your website name,
Take a minute or two to decide

Please Enter "Choice 1" 
Preferred User Name#2 *
  "Choice 2"
Password (6-20 Characters) *
for your FORCE website back office
What City Were You Born?
 *
 (must be 5 characters minimum)
Ship To Address
Ship to City, State, Zip
   Contact Information
PRIMARY Phone *
PRIMARY Email *
Confirm Email *
   Payment Information
Name On Card *
    Credit Card Number *

Please insert - (hyphen) between number groups
Expiration Date (Mo/Yr) *
CVS No: *
3 numbers on back, AE has 4 digits on front
Street Address *
City, State *
Postal Code *
   Anything Else or You Need Help
                    Question/Comments >>>>
   Check if you want Free info

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   Order Information

   Please Note
     1.  Shipping and Sales Taxes are calculated and added to your total when your order is processed
     2.  Auto Ship orders are processed 4 weeks from the date of your initial order.
     3.  A web site fee of $9.95 per month will be added to your monthly Auto Ship total.
     4.  Pricing shown above reflects initial application fee of $49.00


By Clicking The SUBMIT Button Below:

I hereby authorize For Earth Inc. to charge my credit card for any order I place or for the amount of the Auto Ship order I have established.

I understand the orders(s) may include shipping fees and sales tax.

For Earth offers a 30 Day Money Back satisfaction guarantee on UNOPENED products that are returned to the company within 30 days from the date of shipment.

There will be no refunds after 30 days from the shipping date.

DO NOT RETURN OPENED BOTTLES AS THEY MAY LEAK IN TRANSIT AND ARE NOT REFUNDABLE.

Since For Earth products are sold in multi-packs, refunds are prorated based on unopened returned bottles. There will be a 25% restocking fee on the purchase price of the unopened bottles returned.

I understand this is temporary information to be used to set up a
For Earth distributorship online and I must abide by all policies and procedures.
 



















Copyright 2009, Wealth Building 24-7 LLC, All Rights Reserved.
permission from For Earth FORCE
3 Easy Ways To Enroll
Complete This Simple Online Form
or You May Print This Page & Fax to 502-896-6688
Call (502) 896=2595