Important Please read, print and return ASAP
This is not an order form but an interest form

Name: ____________________________________________________ Date: __________________

Address: ____________________________________ City: ____________ St: ____ Zip: _________

Phone: _______-_______-________ Fax: _______-_______-________



Mail or Fax to MLMIA ASAP
Can be generic or private label programs for your Distributors.

Revenue sharing.

p $1,000,000 of LIABILITY INSURANCE for Distributor (from $3 to $15) ______

p International Med-Care. At an annual member cost of only $45 per household _____

p Health Care Program No cost individual/family $25.00

p Multiple Benefits Package - $39.95

Vacation Club Discount travel - Airline Discounts- Buyers Club Savings up to 50% on wide variety name brand products. Up to 50% discounts at over 2,000 hotels, motels & resorts worldwide. - Car Rental Discounts National Golfers Network Magazine Discounts More!

Fax to: MLMIA 949 854 7687 Email to: [email protected]

Mail to: MLMIA 119 Stanford Court Irvine, CA 92612

IMPORTANT: A MLMIA representative will call to discuss benefits you checked. Please state best times to call. AM __________ or PM_________.