DISTRIBUTOR APPLICATION & AGREEMENTLifevantage Distributor Agreement • July 31st, 2018 • New South Wales
(Please attach organisational documents) *Tax File Number (Required if not using TFN for Business Name) Tax File Number for Business Name (Required if not using individual TFN) *Birth Date (DD/MM/YYYY ) (Applicant must be 18 years or older) *Gender F M (Optional) Contact Information ( ) - ( ) - ( ) - *Home Phone Cell Phone Fax Number
DISTRIBUTOR APPLICATION & AGREEMENTLifevantage Distributor Agreement • July 31st, 2018
By checking this box and submitting my personal information, I consent and agree that LifeVantage, its distributors in my Organization/organization or a third party acting for LifeVantage may contact me at my provided email address and/or telephone number and as updated using automated technology such as an auto-dialer or pre-recorded message, text message or email at my cost at my carrier's standard rates for calls and/or texts. I may opt-out from text messages at any time by replying "STOP". I consent and agree that my provided personal information to include my name, addresses, phone and fax numbers, sales data and banking information will be transmitted to LifeVantage and trusted third parties in the United States of America ("USA") to support my LifeVantage account, product orders and their fulfillment. I understand that I may access and rectify my data as well as opt-out of any data transfer to the USA by contacting LifeVantage Compliance at compliance@lifevantage.com. I understa
