membership form with cleanse cost

I N D E P E N D E N T A S S O C I A T E

MEMBERSHIP AND PERSONAL GOALS FORM

Personal Info:

Name Date

Mailing Address

Zip/Postal Code

Phone (Day) Cell Phone

Email

Birth Date Soc. Security# or Tax ID#

Shipping Address

Zip/Postal Code

Drop Ship Address

Zip/Postal Code

Web Set Up:

User Name Password

Health and Wealth Goals: (Optional)

1) On a scale of 1-10 ~ my motivation to improve my health and well-being is

2) My weight goal is to lose pounds and inches in days or week (s)

3) My personal Isagenix® health goal is mainly to be vibrant, energetic, clean and lean

4) On a scale of 1-10 ~ my interest in improving my financial well-being is

5) My financial goal is to earn an additional $ per month in months

6) I’m interested in learning more about the Isagenix® Income Opportunity Yes No

Initial Product Order:

Autoship Order:

Credit or Debit Card Information:

Name on Card

Card Number Exp. Date CCV#

Credit Card Billing Address

Zip/Postal Code

1) Retail: Just want to try the Product ~ no interest in wholesale savings or the business.

2) Wholesale Membership: Interested in long term health benefits, wholesale savings, or the business.

$39 Membership Fee

GET STARTED TODAY !

(Not needed for Retail, Preferred Customer, or Canada)

(If different from above mailing address)

(If taking products now)

Example: www.(UserName).isagenix.com

(at least 6 characters)

(One year wholesale prices, complete website, income opportunity)

(if different from above)

TWO WAYS TO PURCHASE ISAGENIX PRODUCTS:

(Your monthly Product choice)

Jan 25, 2009

2 - Cleanse For Life1 - Shake1 - Snacks1 - Accelerator Capsules

9-DAY PROGRAM PAK

4 - Cleanse For Life

2 - Cleanse For Life4 - Shakes1 - Snacks1 - Accelerator Capsules1 - Ionix Supreme1 - IsaFlush4 - Want More Energy Packets

*1 - Cleanse For Life2 - Shakes1 - Ionix Supreme 1 - Men’s or Women’s Essentials1 - Antioxidant

CLEANSE STARTER PAK

(replaces 26 meals)

(replaces 68 meals)

TOTAL HEALTH & WELLNESS PROGRAM( Mai nt enance)

30-DAY PROGRAM PAK

WHAT DOES THE ISAGENIX® CLEANSE COST

CLEANSING PRESIDENT’S PAK

SHAKE AND CLEANSE PAK

2 - Cleanse For Life2 - Shakes

1-30-Day, 2 Cleanse, 1 IsaDelight (30 ct), 1 WME canister, 1 IsaFruits,1 IsaOmega, 2 IsaLean Soup packets (US), 3 packets IsaLean Shake (CAN.),

1 SlimCakes (US), 2 IsaLean Bars, IsaDermix: Body Wash; Body Polish; Hand & Body Lotion; Welcome Kit/ Product Catalog, $50 Event Certificate.

AUTOSHIPWHOLESALE RETAILREWARDS

ADD-ONS

Ionix Supreme

IsaFlush IsaGreens

IsaFruits

PRODUCT WHOLESALE RETAIL






(replaces 28 meals)

(replaces 34 meals)

FREE $39.00 MembershipFREE IsaBlender

$39 MEMBERSHIP FEE (ONE YEAR WHOLESALE PRICES, COMPLETE WEBSITE, INCOME OPPORTUNITY). SHIPPING AND TAXES NOT INCLUDED. PRICES ARE IN $ U.S. JULY 25, 2010

BEST PRODUCT

VALUE

BEST BUSINESS

VALUE

IsaWater

Ageless Actives

$26000 $29900 $37400

$382 / Meal $438 / Meal $550/ Meal

$13000 $13900 $17400

$500 / Meal $535 / Meal $669 / Meal

$13500 $13800 $18500

$482 / Meal $493 / Meal $660/ Meal

$17700 $18700 $24900

$520 / Meal $550 / Meal $732/ Meal

$12500 $12800 $17500

$3125 /Bottle $3200 /Bottle $4375 /Bottle

$3900 $5200

$2900 $3900

$3200 $4300

$1700 $2200

$3200 $4000

$3200 $4200

NA $54900 NA

Ageless ActivesIsaWaterIonix SupremeIsaFlushIsaGreensIsaFruits

membership form with cleanse cost

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