Distribution: White- Herbalife’s copy Canary- Applicant’s copy Form 4010-USEN-47 Rev. 11/16
Reproduction of this page in whole or in part is prohibited. Copyright © Herbalife. All rights reserved. Printed in USA.
Distribution: White- Herbalife’s copy Canary- Applicant’s copy Form 4010-USEN-47 Rev. 11/16
Reproduction of this page in whole or in part is prohibited. Copyright © Herbalife. All rights reserved. Printed in USA.
Herbalife takes pride in the policies we have in place to protect all of our Distributors.
Please review the Gold Standard Guarantees and check each box to acknowledge that you
have read and understand each item.
1
There are no minimum purchases required and start-up costs are low.
The only required purchase to become an Herbalife Distributor or engage in the Herbalife
business is the International Business Pack. No product purchases are required. If I choose to purchase products, I understand my purchases
should not exceed my own needs or amounts I am confident I can resell in a reasonable amount of time.
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I have read and understood this message
2
There is a fully refundable, 12-month money-back guarantee for the cost of the International Business Pack, if Distributorship
is canceled for any reason, including the shipping cost to return the Pack. To obtain a refund, Distributors may call Herbalife at
866-866-4744 or submit the refund form available at MyHerbalife.com (http://hrbl.me/InventoryRefund).
If I choose to cancel my Distributorship within 12 months, I have the right to a full refund of the purchase price of the International Business
Pack, including the shipping cost to return the Pack.
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I have read and understood this message
3
There is a 100% refund guarantee on unopened products, including taxes and handling costs, that were purchased in the previous
12 months if Distributorship is canceled for any reason. The cost of shipping, both the initial delivery and return shipping, will
also be refunded. To obtain a refund, Distributors may call Herbalife at 866-866-4744 or submit the refund form available at
MyHerbalife.com (http://hrbl.me/InventoryRefund).
If my Distributorship is canceled for any reason, I may return to the company unused and resalable products or sales materials that I
purchased in the previous 12 months for a full refund of the purchase price, including taxes, handling and shipping, both the initial delivery
and return shipping costs.
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I have read and understood this message
4
There is no requirement to purchase any sales and business tools to start up or succeed in your Herbalife Distributorship.
I am not required to purchase any business tools, and can use the promotional literature and sales tools that Herbalife makes available for free or
at minimal cost. I understand that I must successfully complete the “Protecting Your Business 101” training (available on MyHerbalife.com) within
60 days of my qualification as a new Supervisor, or a hold will be placed on any earnings I may be eligible to receive until the training is successfully
completed. Prior to opening a Nutrition Club, including any Club with fitness activities, I must be a Distributor for at least 90 days and complete
the Company’s Mandatory Nutrition Club Operator’s training available on MyHerbalife.com.
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I have read and understood this message
5
We clearly define the benefit of each product and appropriate method of use directly on the product label − we want to make
absolutely sure that the right products are taken the right way to achieve realistic results. We provide realistic expectations of
the business opportunity and the effort required to succeed at all levels.
We clearly define the benefit of each product and appropriate method of use directly on the product label − we want to make absolutely sure
that the right products are taken the right way and that Distributors have the correct information to talk about the products to their customers.
Similarly, we provide accurate information about the financial results that Herbalife Distributors have achieved so that it may be shared with
those being introduced to the Herbalife business opportunity. Any claims I make about Herbalife
®
products or about the Herbalife business
opportunity must be lawful, true, not misleading, substantiated in writing in advance and consistent with claims made in the current materials
published by Herbalife. I may not make any written, therapeutic or curative claims about Herbalife
®
products (whether or not they are about
my own personal experience), except those stated in materials published by Herbalife, or use the name of the Food and Drug Administration
(FDA) or any other regulatory agency when representing Herbalife
®
products.
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I have read and understood this message
6
We provide clear, accurate, and timely disclosures to prospective Distributors regarding potential income.
I understand that it takes hard work, dedication and skill to make an Herbalife Distributorship successful. I understand that the Statement of
Average Gross Compensation that follows is available on MyHerbalife.com, and is the only authorized information about the financial results
that Herbalife Distributors have achieved. I confirm I am not relying on any other information.
To see all of your rights and obligations as an Herbalife Distributor, please review Herbalife’s Rules of Conduct in your Business Pack or visit
MyHerbalife.com.
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I have read and understood this message
I hereby acknowledge that I understand the Herbalife Gold Standard Guarantees.
Applicant’s Signature: ___________________________________________________________________________ ______ /______ /______
Month Day Year
GOLD STANDARD GUARANTEES
IDENTIFICATION NUMBER
The number above will be my Herbalife
ID Number once this Application
is accepted
APPLICANT INFORMATION
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Last Name First Name Middle Initial
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Residential Address (P.O. Boxes are not accepted)
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City State ZIP Code
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Country Code Area Code Day Phone Area Code Mobile Phone Area Code Evening Phone
What is your preferred language for certain communications when available? English □
Spanish □
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Email Address (if applicable) Your email address must be unique and not shared by another Distributor. By providing your email address, you have consented to receive commercial email communications from Herbalife.
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Date of Birth (month - spelled out) (day) (year)
Applicant’s Social Security Number or Spouse’s Social Security Number or
Individual Taxpayer Identification Number Individual Taxpayer Identification Number
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Spouse’s Last Name First Name Middle Initial
Spouse’s name is for recognition purposes only and is not an indication of ownership or entitlement.
SUPERVISOR’S INFORMATION
_______________________________________________________________
Supervisor’s Name (print)
_______________________________________________________________
Phone
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Supervisor’s Herbalife ID Number
SPONSOR’S INFORMATION
_______________________________________________________________
Sponsor’s Name (print)
_______________________________________________________________
Phone
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Sponsor’s Herbalife ID Number
HERBALIFE INTERNATIONAL OF AMERICA, INC.
P.O. Box 80210
Los Angeles, California 90080-0210
Tel: (310) 410-9600
Sales Order Department
Tel: (866) 866-4744
TTY User: (800) 503-6180
IDENTIFICATION NUMBER
The number above will be my Herbalife
ID Number once this Application
is accepted
HERBALIFE DISTRIBUTORSHIP APPLICATION AND AGREEMENT
This Application must be completed accurately and in its entirety in order to be considered by Herbalife International of America, Inc.
A
DISTRIBUTORSHIP
1.
Becoming a Distributor: Thank you for applying to become an Herbalife Independent Distributor (“Distributor”). You will become a Distributor
only when we (Herbalife International of America, Inc.) accept your application and your Distributorship is entered into our records. The terms and
conditions of our Agreement are found in this application, the Sales and Marketing Plan, Rules of Conduct (“Rules”) and other documents posted on
MyHerbalife.com and contained in Book 4 in your International Business Pack (“IBP”) (collectively the “Materials”). We may revise the Materials from
time to time in our discretion, so we encourage you to regularly visit MyHerbalife.com. You acknowledge that you will be required to successfully
complete Herbalife Distributor training in order to purchase Herbalife
®
products for resale, recruit others to become Herbalife Distributors or Preferred
Members, or receive multi-level compensation from Herbalife.
2. Prior Distributorship or Preferred Membership: If you and your spouse have never participated in an Herbalife Distributorship or as a Preferred
Member please skip to 3 below.
If you or your spouse owned or participated in an Herbalife Distributorship in the past year, you may not apply for a new Distributorship under a different
Sponsor until twelve (12) months from the date you last participated in the Distributorship, or your Distributorship was terminated, whichever is later.
For any prior Distributorships, please provide the information requested below:
Your or/Spouse’s Prior Distributorship ID: Name:
Application Date: / / . Date of last activity in connection with that Membership / / .
Month Day Year Month Day Year
If you or your spouse were an Herbalife Preferred Member in the past year, you may not apply for a Distributorship under a different Sponsor until twelve
(12) months from the date your Membership was terminated. For any prior Preferred Membership, please provide the information requested below:
Prior Membership ID: Name:
Application Date: / / . Date of termination of Preferred Membership / / .
Month Day Year Month Day Year
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