Annique Independent Registration Form (Michelle Goodwin)

Annique Independent Registration Form

Michelle Goodwin (602854) - +27 (083) 547 8413 - michelle@rooibos-miracle.co.za
🌟 Are You Ready to Transform Your Life? 🚀

If you are serious about making a positive change in your life, then this opportunity is for YOU! 🎉

But let’s be clear:

This is not just a casual side hobby to try when you feel like it. And if you’re just curious, this might not be the right fit.

💰 However, if your goal is to earn an additional R8000+ per month within a year, then it’s time to make a commitment to yourself and your future! 🎯

If you’re ready to go all in and take the necessary steps to create a thriving, successful business, then continue to complete the form —and we’ll be here to guide and support you every step of the way! 💪✨

📌 To be successful, you need to have access to:

✔️ Facebook
✔️ A working email address 📧
✔️ WhatsApp 📱
✔️ A smartphone, tablet, or computer 💻
✔️ Reliable WiFi or data (24/7) 🌍
✔️ An understanding that this is not passive income—it requires effort! 🔥
✔️ At least 1 hour a day to dedicate to your success ⏳
✔️ A good video-watching & PDF app on your phone 🎥📄

💡 No costs involved. No risks. Just a golden opportunity to build the life you’ve always wanted.

🚀 You have NOTHING to lose and EVERYTHING to gain. But if you don’t try, you’ll never know what’s possible!

🔗 Ready to take the leap? Complete the form now and let’s get started! 🎯✨

First Name*
The name that everyone knows you by
Surname*
Title *
Cell Number*
WhatsApp Number*
i
Home Language*
Preferred Language*
Birthdate*

DayMonthYear
Use this format dd-mm-yyyy
Email*

Confirmation EmailEmail address needs to match in both rows
Physical Address - where your parcels will be sent to
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
YOU DO NOT NEED TO COMPLETE THIS 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 scam or spam
- to verify that you are not currently an Annique consultant
- to register you on the Annique website so that you can receive your own unique consutant number
If you only have a Passport Number then you will need to upload your work permit and proof of South African Bank account below.

Just to confirm that all the information you have completed is true and correct
YESNO
Signed:*

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

DayMonthYear
Date
Should be Empty:

Annique Independent Registration Form

Private information

Just to confirm that all the information you have completed is true and correct