Preferred Customer Order Form â Save 10% - reliv
Preferred Customer Order Form — Save 10% Four Easy Wasy to Enroll:
ITEM #
1.
Enroll and order online at reliv.com/join-reliv
2.
Call 800.735.4887
3.
Fax completed enrollment/order form to 636.537.9753
4.
Mail Completed for to: Reliv Inc. P.O. Box 405 Chesterfield, MO 63006
CUSTOMER NAME (LAST, FIRST)
RCN (LEAVE BLANK IF NEW CUSTOMER
SHIPPING ADDRESS (NO PO BOX)
CITY
STATE
ZIP
EMAIL
PHONE
(
DESCRIPTION
RETAIL
PRICE
91022 Reliv Classic®
$55
$49.50
91012 Reliv Now®
$55
$49.50
91020 Innergize!® – Lemon
$26
$23.40
91021 Innergize!® – Orance
$26
$23.40
91062 FibRestore®
$50
$45.00
91016 Reliv Now® for Kids – Vanilla
$32
$28.80
91017 Reliv Now® for Kids – Chocolate
$32
$28.80
91025 Arthaffect®
$66
$59.40
91027 ReversAge®
$90
$81.00
91041 ProVantage®
$44
$39.60
91042 SoySentials®
$44
$39.60
9110
$110
$99.00
91045 Reliv Delight®
$15
$13.50
91007 GlucAffect®
$70
$63.00
91080 Reliv 24k® Bottle
$52
$46.80
92060 LunaRich X™ Capsules (60)
$40
$36.00
92120 LunaRich X™ Capsules (120)
$80
$72.00
CardioSentials®
)
–
)
–
92012 Reliv Now® Super Pack
$380
$342
92022 Reliv Classic® Super Pack
$380
$342
)
–
91346 Fit3™ Active
$112
$100.80
DISTRIBUTOR
92347 Fit3™ Burn
$41
$36.90
NAME (LAST, FIRST)
92350 Fit3™ Purify
$41
$36.90
1646
$500
$450
WORK
( CELL
(
RCN#
Fit Kit
PCFEE Preferred Customer Annual Fee PAYMENT METHOD VISA
MASTERCARD
DISCOVER
AMEX
MONEY ORDER/CASHIER’S CHECK
CARD NUMBER
EXP. DATE
Are you a new Preferred Customer? If so, include the $10 Preferred Customer Annual Fee (PC FEE) with your order.
QTY
TOTAL
$10.00
SUBTOTAL TAX
+
P&H* (calculated using Subtotal) + Add $9 (orders under $150) Add 6% (orders $150-$999.99) Add 5% (orders $1,000–$2,99.99) Add 3% (orders $3,000 and over)
NAME ON CARD
TOTAL = Subtotal + Tax + P&H
BILLING ADDRESS
A 15% packaging and handling fee combined with $20 surcharge will be assessed on all orders shipped to Bermuda. Note: Prices subject to change without notice. Add sales tax where applicable. *
7/17
ITEM #
1.
Enroll and order online at reliv.com/join-reliv
2.
Call 800.735.4887
3.
Fax completed enrollment/order form to 636.537.9753
4.
Mail Completed for to: Reliv Inc. P.O. Box 405 Chesterfield, MO 63006
CUSTOMER NAME (LAST, FIRST)
RCN (LEAVE BLANK IF NEW CUSTOMER
SHIPPING ADDRESS (NO PO BOX)
CITY
STATE
ZIP
PHONE
(
DESCRIPTION
RETAIL
PRICE
91022 Reliv Classic®
$55
$49.50
91012 Reliv Now®
$55
$49.50
91020 Innergize!® – Lemon
$26
$23.40
91021 Innergize!® – Orance
$26
$23.40
91062 FibRestore®
$50
$45.00
91016 Reliv Now® for Kids – Vanilla
$32
$28.80
91017 Reliv Now® for Kids – Chocolate
$32
$28.80
91025 Arthaffect®
$66
$59.40
91027 ReversAge®
$90
$81.00
91041 ProVantage®
$44
$39.60
91042 SoySentials®
$44
$39.60
9110
$110
$99.00
91045 Reliv Delight®
$15
$13.50
91007 GlucAffect®
$70
$63.00
91080 Reliv 24k® Bottle
$52
$46.80
92060 LunaRich X™ Capsules (60)
$40
$36.00
92120 LunaRich X™ Capsules (120)
$80
$72.00
CardioSentials®
)
–
)
–
92012 Reliv Now® Super Pack
$380
$342
92022 Reliv Classic® Super Pack
$380
$342
)
–
91346 Fit3™ Active
$112
$100.80
DISTRIBUTOR
92347 Fit3™ Burn
$41
$36.90
NAME (LAST, FIRST)
92350 Fit3™ Purify
$41
$36.90
1646
$500
$450
WORK
( CELL
(
RCN#
Fit Kit
PCFEE Preferred Customer Annual Fee PAYMENT METHOD VISA
MASTERCARD
DISCOVER
AMEX
MONEY ORDER/CASHIER’S CHECK
CARD NUMBER
EXP. DATE
Are you a new Preferred Customer? If so, include the $10 Preferred Customer Annual Fee (PC FEE) with your order.
QTY
TOTAL
$10.00
SUBTOTAL TAX
+
P&H* (calculated using Subtotal) + Add $9 (orders under $150) Add 6% (orders $150-$999.99) Add 5% (orders $1,000–$2,99.99) Add 3% (orders $3,000 and over)
NAME ON CARD
TOTAL = Subtotal + Tax + P&H
BILLING ADDRESS
A 15% packaging and handling fee combined with $20 surcharge will be assessed on all orders shipped to Bermuda. Note: Prices subject to change without notice. Add sales tax where applicable. *
7/17
