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2. DISTRIBUTOR APPLICATION
Amended
FOR INDIVIDUALS
Distributor ID No. _______________
APPLICANT INFORMATION SPOUSE INFORMATION
LAST NAME FIRST PREFERRED (ชึ่อเล่น) LAST NAME FIRST PREFERRED (ชึ่อเล่น)
THAI NATIONAL ID CARD NUMBER THAI NATIONAL ID CARD NUMBER
DATE OF BIRTH (dd/mm/yyyy) DATE OF BIRTH (dd/mm/yyyy)
CELL PHONE SPOUSE CELL PHONE HOME PHONE FAX
EMAIL ADDRESS
BILLING ADDRESS NO. & VILLAGE ROAD SUB DISTRICT DISTRICT PROVINCE POSTAL CODE
SHIPPING ADDRESS (if different from above) NO. & VILLAGE ROAD SUB DISTRICT DISTRICT PROVINCE POSTAL CODE
SPONSOR INFORMATION
SPONSOR’S NAME PHONE SPONSOR’S ID NUMBER
PLACEMENT INFORMATION
PLACEMENT NAME PLACEMENT ID NUMBER
CHOOSE ONE L R
(Required)
If the placement you’ve requested has been taken, you will be placed in the next available position on the leg you have indicated above.
VIRTUAL OFFICE (TEMPORARY) PASSWORD*
* Allows you to access your Virtual Office upon enrolment. When you log in, you may change the temporary password.
o By checking this box, I agree that I have read MonaVie’s online sales policy as described below, and will comply with the same. I understand that failure to abide by this policy
may result in penalties without further notice, up to and including termination of my MonaVie Distributor account.
IMPORTANT NOTICE: MonaVie Distributors are prohibited from listing, marketing, advertising, promoting, discussing, or selling any MonaVie product, service or the business
opportunity on any website or online forum that offers auction as a mode of selling (e.g., eBay, Amazon). Please refer to Section 4.4.2 of our Policies and Procedures for complete
details. By signing below, you acknowledge receipt of this formal warning. Those found to be in violation of this policy are subject to penalties without further notice, up to and
including termination of their MonaVie Distributor account.
ACKNOWLEDGEMENT
I understand the only financial requirement to become a MonaVie Distributor is a HK$80 enrolment fee. Once my application is accepted, I understand I may access a distributor
kit online that contains sales and demonstration materials and that I will be entitled to all services the Company provides to its distributors. Any product purchase in connection with
becoming a distributor is optional. I authorise the Company to charge the HK$80 enrolment fee to the payment method provided for my initial order. I have read and agree to the
Terms and Conditions herein and the Compensation Plan and the Policies and Procedures and agree to be bound by them. The Terms and Conditions, the Policies and Procedures,
and the Compensation Plan are fully incorporated into this Distributor Application by reference. I certify that I am 20 years of age or older and am legally able to enter into this
contract.
signature date signature date
X X
Email: Thailand@monavie.com
3. LAST NAME (please print) FIRST PREFERRED (ชึ่อเล่น) DISTRIBUTOR ID NO. (if known)
INITIAL ORDER
Your initial order can differ from your AutoShip order. Simply enter the items you wish to receive on your initial order here.
ITEM NO. QTY. PRODUCT NAME PV WHOLESALE PRICE
†
Total includes shipping. TOTAL†
VISA MASTERCARD
CREDIT CARD NUMBER CV V/CID CODE† EXPIRY DATE
NAME (as shown on card) SIGNATURE OF CARDHOLDER‡ DATE
BILLING ADDRESS NO. & VILLAGE ROAD SUB DISTRICT DISTRICT PROVINCE POSTAL CODE
SHIPPING ADDRESS (if different from above) NO. & VILLAGE ROAD SUB DISTRICT DISTRICT PROVINCE POSTAL CODE
†
This is the 3 digit number found on the back of the credit card.
‡
I certify that this signature is mine and that I am the cardholder named herein. I authorise the Company to charge my card for the initial order.
AUTOSHIP PROGRAM
This optional program allows you to establish a recurring order with MonaVie. Your product will be delivered to you every 28 days at the
wholesale price. Your first AutoShip order will be shipped and billed 28 days from your initial order. Subsequent AutoShip orders will be shipped
and billed on 22–28 day rolling cycle. Any change to your AutoShip order must be submitted to the Company not less than three business days
prior to your next AutoShip order.
ITEM NO. QTY. PRODUCT NAME PV WHOLESALE PRICE
* Total includes shipping. TOTAL*
AUTOSHIP PAYMENT OPTIONS
VISA MASTERCARD
CREDIT CARD NUMBER EXPIRY DATE (mm/yy)
BILLING ADDRESS NO. & VILLAGE ROAD SUB DISTRICT DISTRICT PROVINCE POSTAL CODE
NAME (as shown on card) SIGNATURE OF CARDHOLDER†
X
†
I certify that this signature is mine and that I am the cardholder named herein. I authorise the Company to charge my card for this and subsequent AutoShip.
orders.
AUTOSHIP DELIVERY INFORMATION SAME AS INITIAL ORDER OR FILL IN BELOW
NAME
SHIPPING ADDRESS NO. VILLAGE ROAD SUB DISTRICT DISTRICT PROVINCE POSTAL CODE
Email: Thailand@monavie.com
4. TERMS AND CONDITIONS (NOT-FOR-RESALE) be made by MonaVie to reprocess the order should my payment
method decline; however, MonaVie makes no assurances that
I hereby submit my Application to participate in MonaVie’s these attempts will be made. If a credit card is due to expire, I
Compensation Plan. These Terms and Conditions are incorporated acknowledge that my issuing bank may update my expiration
into my Application MonaVie may accept or refuse my Application date automatically, which will allow MonaVie to process my order
at its own discretion. I certify that I am old enough to enter into an payment; however, I agree to be responsible for providing current
enforceable contract in my jurisdiction of residence. payment. I agree that MonaVie reserves the right to change my
1. Parties. I understand that I am contracting with MonaVie Hong AutoShip orders to subsequent payment methods added by me if
Kong, Ltd. (“MonaVie”) for the purchase of its products and the my first payment method declines. The charge sequence will be
right to participate in its compensation plan, and with MonaVie in the order that I list my payment methods in my MonaVie virtual
Exporting, Inc., a U.S. company. MonaVie Exporting, a MonaVie office.
affiliated entity, has the responsibility to promote the sale of 9. If an order cannot be processed due to payment difficulties,
Products internationally. MonaVie will not be held responsible for personal volume
2. Agreement. Unless otherwise defined herein, all capitalized terms shortfalls.
shall have the same meaning assigned to such terms in the Policies 10. Privacy. MonaVie is committed to collecting and using personal
and Procedures. The term “Agreement” shall mean the Consumer information in a fair and lawful manner, ensuring its accuracy,
Application (of which these Terms and Conditions are a part of, keeping personal information only for lawful purposes, not using
the Compensation Plan, and the Policies and Procedures and any or disclosing such information in a manner incompatible with
country or situation-specific addendum(s) thereto, and any other such purposes, and taking appropriate security measures against
written agreement between the Consumer and MonaVie. I hereby unauthorized access, disclosure or destruction in accor¬dance
agree to be bound by the Agreement. with the provisions of any legislation regarding personal
3. Compliance with Laws. I agree to comply with all applicable laws information in the country I am operating in. In addition to the
relevant to conduct of my activities as Consumer and participant personal information provided by the Distributor in connection
in the Compensation Plan under this Agreement. In particular, with its application to become a Distributor, the Distributor
and without limitation, I must not make any actual or potentially acknowledges that other personal information will be collected
misleading or deceptive claims in relation to commissions and by MonaVie, including information generated as a result of its
other rewards that might be derived from conducting activities as work as a Distributor, such as sales figures and other performance
a participant in the Compensation Plan and as a Consumer of details photographs, advancement information, status, or other
MonaVie products. business related information collectively referred to as “Personal
4. Rights. I understand that as a Consumer, I have the right (but not Information”). I acknowledge that the Personal Information will
the obligation) to: be retained by MonaVie and will be used by MonaVie for
a. buy products from MonaVie in accordance with these Terms marketing and other administration purposes. I acknowledge that
and Conditions in such manner as MonaVie may from time to MonaVie may from time to time disclose this Personal Information
time allow in relation to its Consumers generally; in connection with such purposes to other members of MonaVie’s
b. recommend persons for acceptance as MonaVie Consumers group and to other Distributors, all of whom may communicate
(subject to acceptance by MonaVie); with me, including by way of electronic messages. I consent to
c. if qualified, earn bonuses and other rewards pursuant to the MonaVie collecting, retaining, processing and disclosing Personal
Compensation Plan that will be awarded on the same basis Information referred to above. Such information will be held
as it allows to its Consumers generally in respect of legitimate by MonaVie. I understand that I have rights of access to, and
sales of MonaVie products, and not in respect of the mere correction of, this information
introduction of new Consumers to MonaVie. 11. Amendments. MonaVie may be required to amend the
5. Product Returns. I understand that I can return Products I purchase Agreement from time to time. MonaVie agrees to notify me of the
pursuant to the Policies and Procedures. amendments.
6. Independent Contractor. I agree that as a MonaVie Consumer 12. Cancellation. I understand that I may cancel this Agreement,
I am an independent contractor, and not an employee, partner, without penalty, within 14 days of entering into it and that if
legal representative, or franchisee of MonaVie. I agree that I will I do so I am entitled to recover all monies paid to MonaVie.
be solely responsible for paying all expenses incurred by myself, Cancellation must be effected by sending written notice to
including but not limited to travel, food, lodging, secretarial, office, MonaVie via email to thailand@monavie.com. I acknowledge
long distance telephone and other expenses. I UNDERSTAND that the email notice must be from my email of record and include
THAT I SHALL NOT BE TREATED AS AN EMPLOYEE OF MonaVie my name, Customer identification number, password, and
FOR ANY PURPOSE. address.
7. Bonus Payments. I understand that I must not be in breach of 13. Term and Termination. The term of this Agreement is one year,
the Agreement to be eligible to receive Bonuses pursuant to the subject to earlier termination in accordance with this Agreement or
Compensation Plan. in accordance with law. If this agreement is not renewed, or if it is
8. AutoShip. I may elect to have Product sent to me monthly on terminated for any reason, I understand that my right to purchase
an automatically processed order (AutoShip). To change any MonaVie products and receive bonuses will cease. MonaVie
detail pertaining to my AutoShip order, my phoned request or my reserves the right to terminate this Agreement if (i) AFTER NINETY
written request (from my email account of record or via regular (90) DAYS FROM ITS ACCEPTANCE IF I HAVE NOT ORDERED
mail and signed by me) must be received by MonaVie 72 hours ANY PRODUCT OR SPONSORED ANOTHER DISTRIBUTOR or
in advance of the next shipment. I may change my AutoShip if (ii) at any time upon 30 days notice if the Company elects to:
order in my Virtual Office. All orders are subject to applicable (1) cease business operations; (2) dissolve as a business entity; or
VAT, which is included in the order price. Shipping & handling (3) terminate distribution of its products via direct selling channels,
charges will also be added. The credit card listed on my account or (iii) at any time upon not less than 7 days notice and without
will automatically be charged for this order. Orders in which the further notice if I breach this Agreement and fails to remedy the
payment method is declined may not be processed. Attempts may breach before the end of the notice period. . I may cancel this
5. Agreement at any time, and for any reason, upon written notice the extent necessary to make it enforceable and the balance of
to MonaVie at compliance@monavie.com. the Agreement will remain in full force and effect.
14. No Assignment. I may not assign any rights under the Agreement 19. Delays. MonaVie is not responsible for delays in the performance
without The prior written consent of MonaVie. Any attempt to of its obligations under this Agreement when performance is
transfer or assign the Agreement without the express written made commercially impracticable due to circumstances beyond
consent of MonaVie renders the Agreement voidable at the its reasonable control.
option of MonaVie and may result in termination of my business. 20. Governing Law. This Agreement will be governed by and
MonaVie may assign the Agreement to an affiliate without my construed in accordance with the laws of the State of Utah
consent or giving me notice. without regard to principles of conflicts of laws.
15. Release and Indemnification. To the maximum extent permitted 21. Dispute Resolution. All disputes and claims relating to MonaVie,
by law, MonaVie, its parent or affiliated companies, directors, the Agreement, or any other claims or causes of action relating
officers, shareholders, employees, assigns, and agents to the performance of me or another Distributor shall be settled
(collectively referred to as “affiliates”), shall not be liable for, totally and finally by arbitration as set forth in the Policies and
and I release MonaVie and its affiliates from, all claims for Procedures. Nothing in the Agreement shall prevent MonaVie
consequential and exemplary damages for any claim or cause from applying to and obtaining from any court having jurisdiction
of action relating to the Agreement. I further agree to release a writ of attachment, garnishment, temporary injunction,
MonaVie and its affiliates from all liability arising from or relating preliminary injunction, permanent injunction or other equitable
to: (a) my or any other Consumer’s breach of the Agreement ; relief available to safeguard and protect its interest prior to, during
(b) the promotion or operation of a MonaVie business by me or or following the filing of any arbitration or other proceeding or
any other Consumer and any activities related to it, including, but pending the rendition of a decision or award in connection with
not limited to, the presentation of Products or the Compensation any arbitration or other proceeding.
Plan, the operation of a motor vehicle, the lease of meeting or 22. Jurisdiction and Venue. The parties consent to jurisdiction and
training facilities, etc., and agree to indemnify MonaVie and its venue before any federal or state court in Salt Lake County, State
affiliates for any liability, damages, fines, penalties, or other; (c) of Utah, for purposes of enforcing an award by an arbitrator
any incorrect data or information provided by me or any other or any other matter not subject to arbitration. In the event of a
Consumer to MonaVie; (d) my or any other Consumer’s failure dispute, the prevailing party shall be reimbursed attorney’s fees
to provide any information or data necessary for MonaVie to and reasonable travel and accommodation costs by the other
operate its business; or (e) awards arising from any unauthorized party.
conduct that I undertake. I further agree to indemnify MonaVie for 23. Limitation of Action. If I wish to bring an action against MonaVie
any liability, damages, fines, penalties or other awards arising for any act or omission relating to or arising from the Agreement,
from any unauthorized conduct that I undertake pursuant to the such action must be brought within one year from the date of the
Agreement. alleged conduct giving rise to the cause of action. Failure to bring
16. Entire Agreement. The Agreement, in its current form and as such action within such time shall bar all claims against MonaVie
amended by MonaVie constitutes the entire contract between for such act or omission. I agree to waive all claims that any other
MonaVie and myself. Any promises, representations, offers, or statutes of limitations apply.
other communications not expressly set forth in the Agreement are 24. Successors and Assigns. The Agreement will be legal and binding
of no force or effect. upon and inure t the benefit of the parties and their respective
17. Waiver. Any variation or waiver by MonaVie of any breach of successors and assigns.
the Agreement must be in writing and signed by an authorized
officer of MonaVie. Waiver by MonaVie of any breach of the
Agreement by me shall not operate or be construed as a waiver
of any subsequent breach.
18. Severability. If any provision of the Agreement is held to be
invalid or unenforceable, such provision shall be reformed only to