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Independent Distributor Agreement
BIONEERS Natural Medicines & Paradise Promotions Ltd.
Print out, fill in and mail to: Paradise Promotions Ltd., P.O. Box 394,
Novar, Ontario, Canada P0A1R0
or Fax to: 705-788-9360
Call 1-800-332-9964 with questions.
Social Security No./Social Insurance No. : ________________________________________
Federal I.D. No./Corp I.D. NO. : ____________________________OVER 18? Yes__ No__
Name or Business Name and Occupation (last,first,middle initial):
__________________________________________________________________________
Name of Spouse or Partner and Occupation, if applicable (last,first,middle,initial):
_________________________________________________________________
Mailing Address: ____________________________________________________
City - State/Province - Zip/Postal Code: ___________________________________
Street Address (If P.O. Box is listed above - shippers will only deliver to a street address):
___________________________________________________________________
City - State/Province - Zip/Postal Code: ___________________________________
Home Phone: (_____) _____-_________ Business Phone: (_____) _____-__________
Fax#: (_____) ______-______________ E-mail: ______________________________
Resale Tax# (If Any)___________________(Attach copy of certificate)
Team Trainer's Name if applicable (last,first,initial): ___________________
Team Trainer's I.D. Number: ___________
READ BEFORE SIGNING APPLICATION: As an applicant to become a BIONEERS & PPL. Independent Distributor, I understand and agree as follows:
1. I agree that I will read and abide by the Terms & Conditions of BIONEERS & PPL. I understand that the Terms & Conditions are part of this Agreement. I will abide by these and any subsequent changes announced by BIONEERS & PPL.
2. The term of this Agreement is one year from the date that is is received by the company. This Agreement may be renewed thereafter, each year, by submitting the current renewal fee (one dollar) during or before the last calendar month of the one-year term. Failure on my part to ensure the company's receipt of the renewal fee will cause the loss of my position and wholesale purchasing privileges.
3. I certify and agree that my decision to become a BIONEERS & PPL. Independent Distributor is based solely on my personal experiences with the products and my understanding of the written Terms & Conditions and other company literature. No income representations have been made on which I am relying for this decision.
Agreement made this day_________________ 20_____
DISTRIBUTOR'S SIGNATURE (required) X_________________________________