Registration 2 | Norland South Africa

ernest@norlandsouthafrica.co.za

+27736196670 [Pastor Ernest - Leader & Top Presenter]

No.1 8th Avenue, Edenburg, Sandton

Norland SA REG Form 1

Step 1 of 5

Enter Location*
SUBURB/TOWNSHIP CITY/MUNICIPALITY PROVINCE
Name of Sponsor*
Choose Entry Level*
PRIMARY BENEFITS: 1. DIAMOND qualifies you to become a MAJOR STOCKIST. 2. GOLD qualifies you to become a MINI STOCKIST 3. SILVER, GOLD & DIAMOND qualify for LEADERSHIP BONUS UPGRADE: 1. Register and upgrade within 60 days from Registration 2. Miss Registration Upgrade? Wait for Upgrade Promo. 3. To Upgrade, pay the cash difference and choose products 4. To upgrade, select UPGRADE on Product Order Form. QUESTIONS AND QUERIES: 1. Call or Whatsapp Pastor Ernest on 0736196670
APPLICANT'S PERSONAL INFORMATION
Name of Applicant*
First Last
Email*
Enter Email Confirm Email
Cell Phone Number*
Date of Birth*
Date Format: DD slash MM slash YYYY
Passport/ID number:*

APPLICANT'S BANKING INFORMATION
Bank Name*
Account Holder's name*
Enter Account Number*
Branch Code*
Type of Account*

CHOOSE PRODUCTS
MEBO GI*
Price: R520.00 Quantity:
MICRO-MOLECULE PEPTIDES*
Price: R630.00 Quantity:
HERBAL TOOTHPASTE*
Price: R50.00 Quantity:
NOURIPAD ANION SANITARY NAPKIN (245MM)*
Price: R50.00 Quantity:
NOURIPAD ANION SANITARY NAPKIN (280MM)*
Price: R50.00 Quantity:
NOURIPAD ANION SANITARY PANTILINER*
Price: R60.00 Quantity:
HEALTHWAY HYPOGLYCEMIC CAPSULES*
Price: R420.00 Quantity:
HEALTHWAY HYPOGLYCEMIC HERBAL CAPSULES*
Price: R370.00 Quantity:
HEALTHWAY VISION VITALE CAPSULES*
Price: R420.00 Quantity:
HEALTHWAY CALCIUM IRON & ZINC CAPSULES*
Price: R420.00 Quantity:
CHAO LI KANG PROPOLIS-LECITHIN CAPSULES*
Price: R450.00 Quantity:
HEALTHWAY IMMUNE + CAPSULES*
Price: R420.00 Quantity:
HEALTHWAY IMMUNE VITAL CAPSULES*
Price: R630.00 Quantity:
WUQING NOURISHING HEALTH PAD (MALE)*
Price: R1,040.00 Quantity:
WUQING NOURISHING HEALTH PAD (FEMALE)*
Price: R630.00 Quantity:

CHOOSE PRODUCTS (CONTINUED)
DETOX PACK (1 SET)*
Price: R10,360.00 Quantity:
FDA GINSENG CORDYCEPS SINENSIS (TABLET CANDY)*
Price: R420.00 Quantity:
ISLYM*
Price: R350.00 Quantity:
CELLSPA SILKY FACIAL MASK (6PCS)*
Price: R120.00 Quantity:
SUNLIT MOUTH WASH - NEW*
Price: R130.00 Quantity:
SUNLIT KITCHEN OIL CLEANER*
Price: R100.00 Quantity:
SUNLIT WASHING LIQUID*
Price: R100.00 Quantity:
SUNLIT DETERGENT*
Price: R100.00 Quantity:
SHOER KIDS CALCIUM (GRANULES)*
Price: R310.00 Quantity:
SHOER KIDS ZINC (GRANULES)*
Price: R315.00 Quantity:
VITA NATURAL BETA-CAROTENE CAPSULES*
Price: R350.00 Quantity:
HEALTHWAY CUP*
Price: R1,000.00 Quantity:
ENERGY BRACELET (MALE)*
Price: R1,050.00 Quantity:
ENERGY BRACELET (FEMALE)*
Price: R1,050.00 Quantity:
ENERGY BRACELET (FEMALE)*
Price: R1,050.00 Quantity:
MAGIC FRYING PAN (NORMAL)*
Price: R1,540.00 Quantity:
MAGIC FRYING PAN (DEEP)*
Price: R1,540.00 Quantity:
Total
R0.00

Shipping or Courier
R250.00
Shipping includes R100 PostNet to Postnet Courier Services and R150 for Handling.
Choose Shipping or Courier Option*
Nearest Postnet Address + Special Message*
Please advice if you will pick up Stock at Norland Head Office or Cape Town Office. Enter any instructions. Remember you can always contact Pastor Ernest: +27736196670 (Call, SMS or Whatsapp)
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