ACTIVATION PACKS

UNITED STATES
ENROLLMENT
INDEPENDENT DISTRIBUTOR (USD $59 Enrollment Fee)
NuCerity Builder Pack (USD $1,000 / 500 CV)

PREFERRED CUSTOMER (Select from Autoship Options Only)

11 Skincerity, 2 Peptide Plus, 2 Eye Effects 3, 2 Rejuvenating Barrier, 2 Body Silk, 11 Skincerity Brochures, Free Enrollment

NuCerity Success Pack (USD $500 / 250 CV)

5 Skincerity, 1 Peptide Plus, 1 Eye Effects 3, 1 Rejuvenating Barrier, 1 Body Silk

Skincerity Leader Pack (USD $500 / 250 CV)

9 Skincerity

NuCerity Product Pack (USD $250 / 125 CV)

1 Skincerity, 1 Eye Effects 3, 1 Body Silk, 1 Peptide Plus, 1 Rejuvenating Barrier

Neither the purchase of an Activation pack nor participation in AutoShip are required to become a NuCerity Distributor, to remain within the plan, or move up in
rank within the plan. Such purchases are entirely optional.

AUTOSHIP OPTIONS

PREFERRED CUSTOMER - Specify quantity desired in white box.

DISTRIBUTOR ONLY (USD $120 / 100 PV)

SHIP AUTOSHIP IMMEDIATELY

Skincerity (USD $69.95)

Eye Effects 3 (USD $49.95)

Peptide Plus Moisturizer (USD $69.95)

Skincerity (2 bottles)
Skincerity / Rejuvenating Barrier (1 each)
Body Silk (3 bottles)
Eye Effects 3 (3 bottles)
Skincerity / Peptide Plus Moisturizer (1 each)

Body Silk (USD $49.95)

Rejuvenating Barrier (USD $69.95)

When you select your AutoShip package, it will ship in 28 days after your initial order has
shipped unless you desire immediate shipment. This ensures you will never miss a commission
and will keep the product you USE and MARKET arriving on a regular schedule.

ENROLLEE INFORMATION - PLEASE PRINT CLEARLY

Applicants Full Name:
Government ID / SSN:
Phone Number:
Team Office Username:
Mailing Address:
City:

Birth Date (MM/DD/YYYY):

Email Address:
NuCerity Password:

BILLING INFORMATION FOR AUTOSHIP

Card Type:

AMERICAN EXPRESS

State:

Postal Code:

ADDRESS IS THE SAME AS ABOVE

DISCOVER

MASTERCARD

VISA

Card Holders Name:

Billing Address:
State:

City:

Postal Code:

Card No. 1:

Expiration Date (MM/YYYY):

CVV Number:

Card No. 2:

Expiration Date (MM/YYYY):

CVV Number:

SHIPPING INFORMATION FOR AUTOSHIP

ADDRESS IS THE SAME AS ABOVE

Shipping Address:
City:

State:

Postal Code:

SPONSOR INFORMATION
Sponsors ID Number:

Sponsors Name:
Placement Information:

LEFT

RIGHT

Placement ID Number:

I understand by signing below that this enrollment form is abbreviated and not intended as a substitute for full disclosure of the NuCerity Policies & Procedures/Terms and Conditions. I understand that a complete
disclosure of such documentation is available online and must be agreed to at the time of submission of my enrollment application. I authorize my enroller to process this initial order and AutoShip order with the
information I have supplied herewith. By signing this application, I am aware that I accept and will adhere to all the terms and conditions of the NuCerity Policies & Procedures.
I authorize NuCerity to charge my account or credit card for the items I have indicated I would like to purchase. I have the right to cancel my participation in this program at any time with or without reason by
submitting a Written Notice of Cancellation to NuCerity by email, fax, or postal delivery. I further understand and agree that NuCerity may terminate this agreement, with or without reason, upon 30 days advanced
written notice to me. The preceding Terms and Conditions apply only to those enrolling as Distributors.

Signature:

Date:

UPDATED: March 17, 2015