Your Personal Associate

Andrew Lofts

Questions?—Contact Me

Your Personal Associate

Andrew Lofts

Questions?—Contact Me

PhytoSwiss Rep Agreement

*Required field

Applicant Info

Please provide the following information about the applicant(s)
first name:*
 
last name:*
 
email:*
 
company name:
(if applicable)
co-applicant first name:
co-applicant last name:
applicant SSN or Tax ID#:
co-applicant SSN:
cell phone:
 
alternative phone:
 
fax:
 
date of birth
(mm/dd/yy):
//
 

Mailing Info

Please provide the following information
about the rep:
mailing country:

mailing address 1:*
 
mailing address 2:
mailing city:*
 
mailing
state
:*
 
mailing
zip
:*
 
copy mailing info to shipping info
copy mailing info to billing info

Shipping Info

Please provide the following information
about the rep:
shipping country:

shipping address 1:*
 
shipping address 2:
shipping city:*
 
shipping state:*
 

shipping zip:*
 
copy shipping info to mailing info
copy shipping info to billing info

Billing Info

Please provide the following information
about the rep:
billing country:

name on card:*
 
billing address 1:*
 
billing address 2:
billing city:*
 
billing state:*
 

billing zip:*
 
copy billing info to shipping info

Payment

 
Please fill in your card info:
card number:
 
credit expiration (mm/yy):
/
 

Create a Password:

Must be at least 8 characters, contain a number, and contain a special character (*&^%$#@!)
password:*
 
confirm password:*

Web Information

Please fill in the new rep's webalias:
(this is the portion of the address after "phytoswiss.com/")
(phytoswiss.com/webalias)
(ex: you are signing up under andrew)
web alias:*
 
web name:*
 
contact phone number:*
 

Custom Info

You may provide custom text
web text 1:
This text appears on your member page
web text 2:
This text appears on your member page
Optionally, you may upload a picture that will appear on the left of the associate page:
perhaps a portrait photo?
(6144KB max)
(gif, jpg, jpeg, png, tiff, tif)

Optionally, you may upload a picture for the right side of the associate page: (6144KB max)
(gif, jpg, jpeg, png, tiff, tif)

Fees

Marketing Associates pay $135 to register which includes Phyto Swiss® Elite membership!. Each new Marketing Associate receives a Starter Kit, value $535.80.
Upon enrollment, I understand that I will be charged $135.00 registration fee and shipping costs on the Starter Kit.

Marketing Associate web site and email service maintenance fees are $15 per quarter.
Annual registration renewal fee is $35.00 which includes membership in Phyto Swiss Elite and one free product.

 
I agree to pay these fees *

When you create and publish graphics, copy, or other content, online or in physical form, that content becomes the property of the company and the company may, at its discretion, share it with other IMAs. The company has the right to approve or disapprove all such content, and you agree to cease publishing any content the company requires you to not publish.

website terms
representative agreement

agree to terms:*
 
I agree
I disagree