SGP Member Automatic Order Form
SGP Member Automatic Order Form How to order
SM
By fax only:
Account Number
Fax this completed form to:
800 130 1598
First Name(s)
include credit card information with your order. If ordering by fax, DO NOT fax twice or mail hard copy of order to Mannatech.
By email only:
Scan and email this form to:
Surname
Ship to Information
[email protected]
First Name(s)
include credit card information with your order. If ordering by email, DO NOT fax or mail hard copy of order to Mannatech.
By mail only:
Send this completed form with credit card information to: MANNATECH SWISS INTERNATIONAL GMBH, C/- MANNATECH AUSTRALIA PTY LTD, LOCKED BAG 5000, ST LEONARDS, NSW 2065. AUSTRALIA
Surname Business Name Street Address
Notice: Product orders are not binding until accepted on behalf of Mannatech Swiss International Gmbh In Coppell, Texas, USA
Post Code
Country
SINGAPORE
Mannatech’s Automatic Order Loyalty Program rewards you a 20% Loyalty Credit each time you generate 3 (three) consecutive Automatic Orders. Loyalty Points are calculated against the total product purchase price (excl shipping) and can be used up to 12 months from the issue date.
Day Telephone
(
65
)
Mobile Telephone
(
65
)
Payment Information (please complete and sign.)
Contact Mannatech’s Customer Service Team on AU 1300 361 878 for more information.
Credit Card Number
Expiry Date
NZ 0800 333 250
MM
SG 800 130 15971
CCV
Y Y
The Card Code Verification (CCV) is an extra code printed on your debit or credit card. CCV for Visa and MasterCard is the final three digits of the number printed on the signature strip on the back of your card. CCV for American Express appears as a separate 4-digit code printed on the front of your card. The CCV is not embossed.
Cardholder Name Day Telephone
(
)
Cardholder Billing Address X Cardholder Signature
Date
authoriSation – your signature is required I understand the Automatic Order will continue until Mannatech receives either my written notification or my verbal notification, by calling 800 130 1598 or showing either termination or a change in the order.
for office use only batch
payment id
____________________
order
X
# _______________
s i g n at u r e
NOTE: Mannatech reserves the right to hold orders for verification of payment. Declined credit card orders will be held for authorisation 10 business days. Notice: Product orders are not binding until accepted by Mannatech, Mannatech Swiss International GmbH.
_____________________
___________ of ___________ __________________________ ALL PRICES IN SINGAPORE DOLLARS SUBSTITUTIONS AND/OR CHANGES CAN BE MADE WITHOUT NOTICE.
PAGE 1 of 2 MOD# 1801616. Updated BP9 2012
SGP Member Automatic Order Form IMPORTANT:
SM
If you do not indicate the date you would like your order to commence the order will be processed 28 days from the date the application is processed and every 28 days thereafter until further notice.
Account Number
D D M M Y Y
Order to Commence:
member AO (SGD $)
QTY
SUBTOTAL
Loyalty points
Code
Product Description
12702
ambrotose AO®
60 capsules
77.50
15.50
13002
ambrotose AO®
240 capsules
256.00
51.20
35302
Ambrotose® complex
75g powder
137.50
27.50
37702
ADVANCED Ambrotose® with β-Carotene/Undaria
120 capsules
81.25
16.25
37502
ADVANCED Ambrotose® with β-Carotene/Undaria
75g powder
137.50
27.50
37602
ADVANCED Ambrotose® with β-Carotene/Undaria
150g powder
256.25
51.25
23002
BounceBack®
60 capsules
77.00
15.40
12002
Catalyst®
120 tablets
88.00
17.60
19302
Em•pact Pre Workout Sports Drink®
360g powder
67.50
13.50
17102
EMPRIZONE®
142g gel
61.25
12.25
16602
OMEGA-3 with vitamin d3
60 capsules
53.75
10.75
36202
GI-PRO BALANCE™
30 slim sticks
41.25
8.25
11502
GlycoSlim® drink mix Chocolate
600g powder
72.50
14.50
11602
GlycoSlim® drink mix Vanilla
600g powder
72.50
14.50
12302
IMMUNOSTART®
60 tablets
68.75
13.75
13502
MANNA•Bears®
300g bears
34.50
6.90
39102
Manna-C®
60 capsules
13.50
150g powder
67.50 98.30
19.66
2x366g powder
165.00
33.00
60 capsules
67.50
13.50
60 chews
55.00
11.00
34302 22202
NUTRIVERUS™ osolean®
15102
Phyt•Aloe®
12802
PHYTOBURST® NUTritIONAL CHEWS
11202
PHYTOMATRIX®
120 tablets
88.00
17.60
11102
Plus™
90 tablets
67.50
13.50
12102
SPORT with Ambrotose®
60 capsules
56.25
11.25
72302
NUTRIVERUS WEIGHT MANAGEMENT AUTOMATIC ORDER KIT
1x 34302 2x 22002
249.70
72902
NUTRIVERUS 75G ADVANCED AMBROTOSE AUTOMATIC ORDER KIT
1x 34302 1x 37502
224.45
72802
NUTRIVERUS 150G ADVANCED AMBROTOSE AUTOMATIC ORDER KIT
1x 34302 1x 37602
336.45
72702
NUTRIVERUS AMBROTOSE COMPLEX AUTOMATIC ORDER KIT
1x 34302 1x 35302
224.45
72602
NUTRIVERUS FAMILY AUTOMATIC ORDER KIT
1x 34302 2x 13502 1x 16616
208.70
72402
NUTRIVERUS SPORT AUTOMATIC ORDER KIT
1x 34302 1x 12102 1x 19302
210.20
74002
NUTRIVERUS ESSENTIALS AUTOMATIC ORDER KIT
1x 34302 1x 16602 1x 36202
210.92
34302
NUTRIVERUS AUTOMATIC ORDER KIT
2x 34302
204.60
TOTAL VALUE ON SELECTED PRODUCTS $ SHIPPING $
TOTAL $ ALL PRICES IN SINGAPORE DOLLARS SUBSTITUTIONS AND/OR CHANGES CAN BE MADE WITHOUT NOTICE.
PAGE 2 of 2 MOD# 1801616. Updated BP6 2013
12.00 (MAX)
SM
By fax only:
Account Number
Fax this completed form to:
800 130 1598
First Name(s)
include credit card information with your order. If ordering by fax, DO NOT fax twice or mail hard copy of order to Mannatech.
By email only:
Scan and email this form to:
Surname
Ship to Information
[email protected]
First Name(s)
include credit card information with your order. If ordering by email, DO NOT fax or mail hard copy of order to Mannatech.
By mail only:
Send this completed form with credit card information to: MANNATECH SWISS INTERNATIONAL GMBH, C/- MANNATECH AUSTRALIA PTY LTD, LOCKED BAG 5000, ST LEONARDS, NSW 2065. AUSTRALIA
Surname Business Name Street Address
Notice: Product orders are not binding until accepted on behalf of Mannatech Swiss International Gmbh In Coppell, Texas, USA
Post Code
Country
SINGAPORE
Mannatech’s Automatic Order Loyalty Program rewards you a 20% Loyalty Credit each time you generate 3 (three) consecutive Automatic Orders. Loyalty Points are calculated against the total product purchase price (excl shipping) and can be used up to 12 months from the issue date.
Day Telephone
(
65
)
Mobile Telephone
(
65
)
Payment Information (please complete and sign.)
Contact Mannatech’s Customer Service Team on AU 1300 361 878 for more information.
Credit Card Number
Expiry Date
NZ 0800 333 250
MM
SG 800 130 15971
CCV
Y Y
The Card Code Verification (CCV) is an extra code printed on your debit or credit card. CCV for Visa and MasterCard is the final three digits of the number printed on the signature strip on the back of your card. CCV for American Express appears as a separate 4-digit code printed on the front of your card. The CCV is not embossed.
Cardholder Name Day Telephone
(
)
Cardholder Billing Address X Cardholder Signature
Date
authoriSation – your signature is required I understand the Automatic Order will continue until Mannatech receives either my written notification or my verbal notification, by calling 800 130 1598 or showing either termination or a change in the order.
for office use only batch
payment id
____________________
order
X
# _______________
s i g n at u r e
NOTE: Mannatech reserves the right to hold orders for verification of payment. Declined credit card orders will be held for authorisation 10 business days. Notice: Product orders are not binding until accepted by Mannatech, Mannatech Swiss International GmbH.
_____________________
___________ of ___________ __________________________ ALL PRICES IN SINGAPORE DOLLARS SUBSTITUTIONS AND/OR CHANGES CAN BE MADE WITHOUT NOTICE.
PAGE 1 of 2 MOD# 1801616. Updated BP9 2012
SGP Member Automatic Order Form IMPORTANT:
SM
If you do not indicate the date you would like your order to commence the order will be processed 28 days from the date the application is processed and every 28 days thereafter until further notice.
Account Number
D D M M Y Y
Order to Commence:
member AO (SGD $)
QTY
SUBTOTAL
Loyalty points
Code
Product Description
12702
ambrotose AO®
60 capsules
77.50
15.50
13002
ambrotose AO®
240 capsules
256.00
51.20
35302
Ambrotose® complex
75g powder
137.50
27.50
37702
ADVANCED Ambrotose® with β-Carotene/Undaria
120 capsules
81.25
16.25
37502
ADVANCED Ambrotose® with β-Carotene/Undaria
75g powder
137.50
27.50
37602
ADVANCED Ambrotose® with β-Carotene/Undaria
150g powder
256.25
51.25
23002
BounceBack®
60 capsules
77.00
15.40
12002
Catalyst®
120 tablets
88.00
17.60
19302
Em•pact Pre Workout Sports Drink®
360g powder
67.50
13.50
17102
EMPRIZONE®
142g gel
61.25
12.25
16602
OMEGA-3 with vitamin d3
60 capsules
53.75
10.75
36202
GI-PRO BALANCE™
30 slim sticks
41.25
8.25
11502
GlycoSlim® drink mix Chocolate
600g powder
72.50
14.50
11602
GlycoSlim® drink mix Vanilla
600g powder
72.50
14.50
12302
IMMUNOSTART®
60 tablets
68.75
13.75
13502
MANNA•Bears®
300g bears
34.50
6.90
39102
Manna-C®
60 capsules
13.50
150g powder
67.50 98.30
19.66
2x366g powder
165.00
33.00
60 capsules
67.50
13.50
60 chews
55.00
11.00
34302 22202
NUTRIVERUS™ osolean®
15102
Phyt•Aloe®
12802
PHYTOBURST® NUTritIONAL CHEWS
11202
PHYTOMATRIX®
120 tablets
88.00
17.60
11102
Plus™
90 tablets
67.50
13.50
12102
SPORT with Ambrotose®
60 capsules
56.25
11.25
72302
NUTRIVERUS WEIGHT MANAGEMENT AUTOMATIC ORDER KIT
1x 34302 2x 22002
249.70
72902
NUTRIVERUS 75G ADVANCED AMBROTOSE AUTOMATIC ORDER KIT
1x 34302 1x 37502
224.45
72802
NUTRIVERUS 150G ADVANCED AMBROTOSE AUTOMATIC ORDER KIT
1x 34302 1x 37602
336.45
72702
NUTRIVERUS AMBROTOSE COMPLEX AUTOMATIC ORDER KIT
1x 34302 1x 35302
224.45
72602
NUTRIVERUS FAMILY AUTOMATIC ORDER KIT
1x 34302 2x 13502 1x 16616
208.70
72402
NUTRIVERUS SPORT AUTOMATIC ORDER KIT
1x 34302 1x 12102 1x 19302
210.20
74002
NUTRIVERUS ESSENTIALS AUTOMATIC ORDER KIT
1x 34302 1x 16602 1x 36202
210.92
34302
NUTRIVERUS AUTOMATIC ORDER KIT
2x 34302
204.60
TOTAL VALUE ON SELECTED PRODUCTS $ SHIPPING $
TOTAL $ ALL PRICES IN SINGAPORE DOLLARS SUBSTITUTIONS AND/OR CHANGES CAN BE MADE WITHOUT NOTICE.
PAGE 2 of 2 MOD# 1801616. Updated BP6 2013
12.00 (MAX)
