AVON Sign up form

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Please note that all fields followed by an asterisk must be filled in.

Title*
Title*

First Name*
First Name*

Last Name*
Last Name*

E-mail Address*
E-mail Address*

Street Address*
Street Address*

City*
City*

Zip/Postal Code*
Zip/Postal Code*

Home Phone*
Home Phone*

Business Phone*
Business Phone*

Date of Birth(DD/MM/YYYY)*
Date of Birth(DD/MM/YYYY)*

Marital Status*
Marital Status*

Current Occupation*
Current Occupation*

Best Time to call*
Best Time to call*

Have you done network marketing before?*
Have you done network marketing before?*

Security Question-What is your Mother's maiden name?*
Security Question-What is your Mother's maiden name?*

I am over 18 years old and agree that my details be passed to my local Sales Leader*
I am over 18 years old and agree that my details be passed to my local Sales Leader*

How long have you been living at your current address?*
How long have you been living at your current address?*

If Less than 2 years Please state the previous full address here*
If Less than 2 years Please state the previous full address here*

Accomodation:*
Accomodation:*

Do you have a Bank Account?*
Do you have a Bank Account?*

	A. Yes
	B, No

If Yes, How Long and you held the account for?*
If Yes, How Long and you held the account for?*

Do you have a credit card ?*
Do you have a credit card ?*

List Two proof of I.D i.e Utility Bill,Driving License,Passport. (Indicate a reference nos on the proof of address)*
List Two proof of I.D i.e Utility Bill,Driving License,Passport. (Indicate a reference nos on the proof of address)*

Would you like AVON to allocate to you streets around your residence where you can drop off your AVON Brochures? *
Would you like AVON to allocate to you streets around your residence where you can drop off your AVON Brochures? *

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