Franchise

Owner Order Form

Phone Order 1-800-UNICITY (864-2489) Fax Order 1-800-226-6232
1201 North 800 East, Orem, UT 84097 ATTENTION: Fax OR mail this form. Sending more than one order form may result in duplicate orders.

Billing Information
PV Month
Franchise Owner ID Number

Item #

Product

Unit Price

Qty

Total

Franchise Owner Name (Last, First, Middle Initial) PLEASE PRINT CLEARLY

Mailing Address

City

State

Zip Code

Business/Daytime Phone

E-mail Address

Shipping Information
Name (Last, First, Middle Initial) PLEASE PRINT CLEARLY

Shipping Address (If different from mailing address or if mailing address is a P.O. Box)

City

State

Zip Code

Business/Daytime Phone

Payment Method

Subtotal Sales Tax

If you have questions on whether sales tax is applicable, please contact Customer Service.

n VISA n MasterCard n American Express n Discover n Money Order

Credit Card Number

Discount Shipping & Handling

Standard shipping is $7.95 min. or 5.75% of total order. Upgrade to Next Day for $21.95 min. or 8.5% of total order.

Expiration (MM/YY) Signature

CVC

TOTAL

*Please verify your shipping address above as you my be subject to fees due to UPS/USPS address corrections. Refused orders will be charged a $10.00 fee per box.

The 70% Rule

Franchise Owners may purchase Unicity products only for resale to consumers, for personal consumption, or to provide prompt product delivery to Downline Franchise Owners in their own personal group. Franchise Owners may not stockpile or acquire excessive inventories. By making any purchase or product order, Franchise Owners certify that they have used or sold a minimum of 70% of all previous orders. By submitting this order, I certify that a minimum of 70% of all Unicity products previously purchased under this Franchise Owner ID number have been sold and/or consumed.

Statement of Responsible Consumption

At Unicity, we believe that proper diet and supplementation have a direct impact on the quality of life. We are proud of our products and are gratified to see the benefit that so many receive from our efforts. As a responsible corporate citizen, we promote and advocate the responsible use of any nutritional supplement or personal care product. Our products are formulated with great care, and labeling guidelines have been developed to guide proper use. Abusive consumption of any product is unwise and may have negative consequences. We encourage everyone to receive the full benefit of Unicity products through wise and informed consumption.

Please Initial

2011 Unicity International, Inc.

Franchise Owners may photocopy this form or download it from www.unicity.net.

US0311 Item 20145