Thirty-One Gifts Canada Inc. c/o Thirty-One Gifts LLC INDEPENDENT SALES CONSULTANT APPLICATION AND AGREEMENT
3425 Morse Crossing • Columbus, Ohio 43219 Phone: 855-GIFTS31 (855.443.8731) • Fax: 614.337.1459 • mythirtyone.ca
APPLICANT INFORMATION Name (First, Middle, Last):
Social Insurance Number:
Email Address:
Telephone:
Cell:
Mailing Address:
City:
Province:
Postal Code:
SPONSOR INFORMATION Name:
Consultant I.D. No:
Email Address:
Telephone:
Enrollment Kit
Payment Information
Each Applicant must purchase a Thirty-One Gifts Canada Enrollment Kit. The Kit contains necessary tools and documents to help you get your Thirty-One Gifts Canada business launched.
¨ MasterCard
Enrollment Kit
Expiration Date (MM/YYYY): _________________
Cdn $115.00*
Kit Choice: Black & White or Neutral Pop (circle choice)
¨ Visa
¨ American Express
¨ Discover
Card No.: _______________________________________________
Name on Card: ___________________________________________ Authorized Signature: _______________________________________ Date:__________________
* Does not include tax or shipping and handling charges. Any Enrollment Kit personalization offered is included for free.
By signing above, I authorize Thirty-One Gifts Canada Inc. to charge my credit card for all orders, website subscriptions and payments indicated on this Application and Agreement. Billing address for credit card must match the Applicant’s address listed above.
For Statement of Buyer’s Right to Cancel, please see page 3. I have carefully read the Terms and Conditions on the back of this Independent Sales Consultant Application and Agreement, the Thirty-One Gifts Canada Career Path and the Thirty-One Gifts Canada Consultant Guidebook (we refer to all of these documents together as the “Agreement”), and agree to abide by all terms set forth in the Agreement. I understand that I have the right to terminate my Thirty-One Gifts independent business at any time, with or without reason, by sending written notice to Thirty-One Gifts at the address listed above. ______________________________________________________________ Applicant’s Signature
_______________________ Date
By signing above, I certify that I have not been a Thirty-One Gifts Consultant within the past six months. I understand that any intentional misrepresentation of any information I provide on this Agreement may result in action by Thirty-One Gifts Canada, up to and including termination of this Agreement. Mail the completed signed original Agreement to: Thirty-One Gifts Canada Inc., c/o Thirty-One Gifts LLC, Attn: CAGS Dept., 3425 Morse Crossing, Columbus, OH 43219, U.S.A. or Fax to 614.337.1459. If you fax the Agreement, please remember to fax both the front and back sides. You will receive an email confirmation once Thirty-One Gifts Canada has accepted your application, and your submission is consent to receiving same. ONE COPY to Thirty-One Gifts
TWO COPIES to be kept by Applicant