Alliance in Motion Global. Inc.

Unit 301 & 320 3/F AIC-Burgundy Empire Tower, ADB Ave, cor. Sapphire & Garnet Sts. Ortigas Centerm Pasig City, Philippines

www.allianceinmotion.com

DISTRIBUTOR APPLICATION FORM
Personal Information
LAST NAME Address Birthdate MM Home Telephone No. E-mail Address Beneficiary Age Relationship Age DD YYYY Mobile No. Status USER NAME FIRST NAME MIDDLE NAME

GLOBAL PACK SALES INFORMATION
Sponsors Name Placement Name Position Signature of Sponsor L R Signature of Appllicant Sponsor ID No. Placement ID No.

PAYMENT INFORMATION
Check Amount Signature For and behalf of Date Cash

GLOBAL PACK PACKAGE
C24 / 7 Business Kit VCD

Brochure

DAF

Endorsement Letter Scholarship

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 SINGLE X MARRIED SEPARATED DIVORCED .

Sign up to vote on this title
UsefulNot useful