Personal Information
 
Individual or Husband/Wife Independent Business Corporation, Partnership or Other Independent Business


Applicant #1 (Last, First, Middle Initial)

Applicant #2 (Last, First, Middle Initial

Applicant #1 Social Security Number

Current Occupation/Profession

Mailing Address, City, State, Zip

Shipping Address, City, State, Zip

Email Address

Sponsors Name (Last, First, Middle Initial)

Sponsors Rep ID Number

 Please complete this Section if you are enrolling as a corporate entity.
Name of Business Entity (to appear on all correspondence)

Name of Principle Partner

Title

Federal Tax ID Number

Evening Telephone

Daytime Telephone

Fax Telephone

Sponsors Telephone
Payment Information Rep Kit Purchase

Card Type
Credit Card Number

Expiration Date (mm/yy)
Name on Card (exactly as it appears)

Cardholders Credit Card Billing Address


I am a new Business For You Independent Representative. Please send me my new Rep Kit. I understand that this kit includes promotional materials, business information and the Business For You muanual. I also understand that no purchase of products or services is required to bocome a Business For yOu Representative. This price includes you New Rep Kit and enrollment in the Business For You Independent Representative program and all that it entitles you to.

Total Remittance $99.95
Enrollment  


I Agree that I have read and accepted all the terms and conditions regarding privileges and obligations as outlined in the Policies and Procedures, the terms of which, by the reference are fully incorporated in this agreement, and are complete and accurate. All signatures to this application must be affixed personally. Applicants must be of legal age in their state of residence. I also understand the only finacial requirment to become a Business For You Independent Representative is the $99.95 Rep Kit which contains sales and demonstration materials and company information produced by Business For You. I understand the required Rep Kit does not contain Business For You products and that any products or services purchased in connection with becoming a Representative are optional.

* Date


Mailing Address:
Business For You New Enrollment
20810 Plummer St.
Chatsworth, CA. 91311
You will receive your New Rep Kit including you New Business For You Independent Representative ID number within 1-2 weeks