Independant Agents & Small Business Owners
Empowering Your Life!
INDEPENDANT AGENT Information
Name
First Name
Last Name
Age
Email
example@example.com
SMALL BUSINESS OWNER Information
Name
First Name
Last Name
Business Name
Business Name
Owners Name
Email
example@example.com
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Social Media Accounts
Instagram
Tik-Tok
Facebook
YouTube
Payment Method
Please Select
PayPal
Purchase Order
Is approval needed for the content created?
needed
not needed
Some Fun Questions
What excites you the most about joining our PowerfulME Essentials team that emphasizes both health and earning opportunities?
Tell us about your experience with health supplements. Which ones have you tried, and what benefits have you experienced?
Now, let's dive into the earning aspect!
.
Are you familiar with direct selling? If yes, tell us about your experience. If not, don't worry – we'll guide you!
How much time can you dedicate to earning with our PowerfulME Essentials team? Full-time, part-time, or just a few hours a week?
Congratulations on taking the first step toward an exciting & rewarding journey with our PowerfulME Team! By joining us, you're not just becoming a team member; you're becoming a part of a vibrant & powerful team that values both health and prosperity. Once you submit this form, our office team will review your application, and if you're a great fit (we think you are!), we'll reach out to you with more details. Together, we'll work towards your goals, celebrate each success, and have a blast doing it! If you have any questions or want to add anything else, feel free to jot it down below. Get ready to embrace the world of PowerfulME health supplements, have fun, and earn along the way!
Do you have any questions or want to add anything else?
Lets Do This!
AN ON-LINE MEETING WILL BE SCHEDULED UPON APPLICATION APROVAL
Date
-
Month
-
Day
Year
Date
Agent/Influencer Signature
Print Form
Submit
Submit
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