Annique Independent Registration Form (MichelleGoodwin)

Annique Rooibos Health & Beauty
Independent Consultant Registration Form

SPONSOR
Michelle Goodwin (602854)
+27(083)547 8413 (WhatsApp Only)
michelle.goodwin@rooibos-miracle.co.za

🌟 Are You Ready to Take Your Future Seriously?

🚀 This opportunity is for individuals who are ready to make a positive and meaningful change in their lives.

🎯 This is not a casual hobby or something to do only when it is convenient.

💛 It is best suited to someone who is committed, teachable, and willing to take consistent daily action.

💰 If your goal is to work towards earning an additional R8 000+ per month within a year, this could be the opportunity you have been looking for.

⚠️ Please remember that results are not automatic or guaranteed — your success will depend on your effort, consistency, learning, and action.

🤝 If you are ready to commit to yourself and your future, we will guide, support, and encourage you every step of the way.

📌 To participate successfully, you will need:

📱 Access to WhatsApp.

💻 Access to Facebook.

📧 A working email address.

🌍 Reliable WiFi or mobile data.

📲 A smartphone, tablet, or computer.

🎥 The ability to watch videos and open PDF documents.

⏳ At least 1 hour per day to focus on learning, growing, and building your business.

🔥 A clear understanding that this is not passive income — it requires effort, action, and commitment.

💡 There are no unnecessary risks; it does not cost you a cent, only an opportunity to learn, grow, and build something meaningful for your future.

🌱 You have nothing to lose by learning more — and so much to gain by taking the first step.

🔗 Complete the form to continue and begin your journey.
I UNDERSTAND AND AGREE TO ALL OF THE ABOVE

First Name
Only fill your preferred name.
Surname
Title
Whatsapp Number
Please enter a valid phone number.Format: 27000000000.
Phone Number
Please enter a valid phone number.Format: 27000000000.
Home Language
Preferred Language
Birthdate

DayMonthYear
Date
Email

Confirmation EmailEmail address needs to match in both rows.

PHYSICAL ADDRESS WHERE YOUR PARCELS WILL BE SENT
Street Address 1
Street Address 2
Suburb
Town
Province
Postal Code

PRIVATE INFORMATION

This information DOES NOT HAVE TO BE COMPLETED : - BUT, it will help the registration to get your unique consultant number a lot easier.
Ethnicity
Marital Status
Gender
RSA Citizen
South African Identity Number / Passport Number
This does not need to be completed now, but would be appreciated.
Your South African ID number is required for the following reasons:

• To verify that you are a real person and not a scam or spam application.
• To confirm that you are not currently registered as an Annique Consultant.
• To register you correctly on the Annique website so that you can receive your own unique Consultant Number.

If you only have a Passport Number, you will also be required to upload the following documents:

• A valid work permit.
• Proof of a South African bank account.

Please confirm that all the information you have provided is true and correct.
Signature

Use your finger, a stylus or your mouse to sign here.
Date

DayMonthYear
Date
Should be Empty: