Agent Application Form (please print & email to info@justbliss.co.za)
JUSTBLISS (PTY) LTD
APPLICATION FORM as JUSTBLiSS AGENT
(Please complete form using a black pen and write in capital letters)
Surname: ________________________________________________________________________
First name: ________________________________________________________________________________________________________________________________________________
Residential Adress: ________________________________________________________________________________________________________________________________________________
ID number: ______________________________________________________________
Date of Birth: ___________________________________________________________
Cell number: ________________________________________________________________________
E-mail: ________________________________________________________________________
Delivery Adress: ________________________________________________________________________________________________________________________________________________
Are you fluent in Afrikaans & English: ________________________________________
Any Other Languages: _____________________________________________________
Are you currently using any of the JUSTBLiSS products? ________________________________________________________________________
________________________________________________________________________________________________________________________________________________
Why have you decided to join JUSTBLiSS as an Agent? ________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Are you full time Employed? _________
If yes, Name of Employer: _________________________________________________
How much do you +- want to earn per month: ________________________________________________________________________
Are you currently an agent for other Company/ies: ________________________________________________________________________
How will you be promoting the JUSTBLiSS products?
________________________________________________________________________
PRIVACY POLICY
Please read our privacy policy at “Private Policy on the JUSTBLiSS Website. Feel free to contact us with any queries regarding this policy. Send an email to info@justbliss.co.za.
I, ______________________________________________________________(Insert full name and surname), the undersigned, hereby acknowledge that I have read the Terms and Conditions Contract or Agreement, and I agree to be bound by them. I also agree that all information in the Application form, supplied by me, is accurate.
New Applicant’s signature_________________________ Date _______________________________________________
Thank you for your interest in becoming part of the JUSTBLiSS family!
PRIVACY
You trust JUSTBLiSS with your personal data, and we promise to keep those safe and use them only for the purpose you shared with us. Please read our privacy policy on our website.
CODE OF CONDUCT & BRAND
At JUSTBLiSS we are committed to following the highest ethical standards and we expect the same from you.
AREAS/NUMBER OF AGENTS APPOINTED
There is no limit per town/city/region, because at JUSTBLiSS we aim to help as many individuals generate an income for themselves or their families. However, in smaller towns we will only appoint one Agent per town.
ORDERING AND PAYMENT
We will send you a notice when an order was accepted. We will not accept any orders until you pay either via EFT, YOCO or Payfast.
DELIVERY
We deliver the products either to your home or to different address if you so wish.
YOUR DISCOUNT
You will earn a discount of 20% of our retail price on all orders made by you. The higher your order, the higher your discount! You can also earn commission on all sales made by the public using your discount code. Once you are accepted as an agent, you will receive a code to be used at checkout.
CONTACT DETAILS AND ADDRESSES
We are JUSTBLiSS (Pty) Ltd, 2019/492065/07. Our address is 72 Waverley Road, Bloemfontein, 9301. You can contact us at info@justbliss.co.za or 083 300 611. We will use the address you provide to send any legal documents to you. Either of us can change our physical address on written notice. Please make sure that you keep your contact details up to date, or you might miss out on important notices.
PLEASE TAKE NOTE OF THE FOLLOWING
If appointed as an Agent, it will be as an independent Agent, and NOT an employee of JUSTBLiSS. If appointed, the Terms and Conditions will be emailed to you, which you will have to sign before official appointment as JUSTBLiSS Agent.
I, ______________________________________________________________(Insert full name and surname), the undersigned, hereby acknowledge that I have read the said Agreement, and I agree to be bound by them. I also agree that all information in the Application form, supplied by me, is accurate.
New Applicant’s signature_________________________ Date _______________________________________________
