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Preferred Customer Agreement 5204 South Procyon Ave, Las Vegas, NV 89118
Office 702-597-5015 Fax 702-597-5094
Please enroll me as a Preferred Customer Please enroll me as a Direct Customer. I’ll receive the retail price
As a Preferred Customer I commit to purchase products totaling at least (check one)
29 or 79 Business Volume each month and I’ll receive 30% to 40% off the suggested retail price of Allegre products plus other Allegre Benefits.
1 New Customer (Please Print)
Last Name First Name Middle Initial Social Security Number
Spouse (If Applicable) Social Security Number
Residence Address (For UPS Delivery) City State Zip
Mailing Address (If Different) City State Zip
Business Telephone Home Telephone Fax Cell/Pager
( ) ( ) ( ) ( )
2 Enroller Information (Please Print)
Last Name (Or Corporate Name) First Name Middle Initial ID# Telephone
77- ( )
3 Placement Information (Please Print)
Last Name (Or Corporate Name) First Name Middle Initial ID# Telephone
77- ( )
4 New Customer Account Information (Please Print)
For your ordering convenience, you may place your checking or credit card account information on file with us. To insure your continued Preferred Customer status, two (or
more) forms of payment are preferred. At least one form of payment is required. All account information must be in the name of the new Customer.
Email Address:
5 Backup Order
Payment made by: Credit Card* (Payment to be made to Allegre) Choose the Preferred Backup Order that
fits your needs. 29
Visa Mastercard American Express Discover
(circle one) 79
1. Credit Card Account Number: Your automatic backup order keeps you in good standing to receive
your Allegre Preferred Customer 30% to 40% discount and other Pre-
ferred Customer Benefits. If you are away on vacation or business,
don’t meet your Business Volume Commitment, or just forget to place
Expiration Date: ________/_________ your order, the Backup Order will be sent automatically, assuring that
you meet your Business Volume commitment and that you receive all
Preferred Customer savings and benefits.
1a. Credit Card Account Number:
Please choose your favorite Allegre products to be shipped to you
should you need a Back-up order. The “Select Pack” order form is on
the reverse side of this agreement.
Expiration Date: ________/_________
If you have chosen to be a Preferred Customer, you must choose a
“Select pack” in order for this enrollment form to
2. Electronic Checking : Attach a voided check for verification of your account number and to
notify your bank of this agreement for pre-authorization.
6 Signature
BY SIGNING BELOW I ACKNOWLEDGE THAT I AM AT LEAST
18 YEARS OLD AND I HAVE CAREFULLY READ AND AGREE TO
Authorized Signature X____________________________________________________
THE ALLEGRE CUSTOMER AGREEMENT TERMS AND CONDI-
TIONS ON THE FRONT AND BACK OF THIS AGREEMENT.
$10 or $29 Enrollment Fee: PAYMENT CHECK ENCLOSED
X _____________________________________________________
Applicant’s Signature (this Allegre Agreement is not valid unless signed.)
BILL MY ACCOUNT INDICATED ABOVE
Date: _______________________
I may cancel this agreement for any reason, at any time, by giving written notice to Allegre
bearing my original signature, printed name, address and Customer number. Written cancellations
will be effective upon receipt by Allegre. Cancellation notices must be mailed to: Allegre, 5204
South Procyon Ave., Las Vegas, NV 89118. Emailed or faxed cancellations will not be accepted.
The Allegre Corporation 2003 Original-Corporate Two-Sponsor Three-Applicant
Customer Agreement
Terms and Conditions
(please read carefully)
The Preferred Customer Backup Order Agreement Changes
If I am enrolling as a Preferred Customer, I agree to purchase products totaling at least To change Backup Order selections, quantities, method of payment, or the authorized
the specified Business Volume (29 or 79) which I selected in Section 5 on the front of amount, a new Preferred Customer Agreement must be submitted to Allegre. If more
this Agreement. I also agree to pay any and all applicable freight charges and local than one Preferred Customer Agreement has been submitted, the most recent agreement
taxes. By enrolling as a Preferred Customer, I authorize Allegre to ship the Backup will supersede all previous agreements. Allegre reserves the right to substitute products
Order designated in this Agreement for any calendar month in which my Personal and/or change prices or Business Volume allocations without notice. Substitutions on
Business Volume does not equal or exceed the Business Volume total designated in the Select Packs will only occur if selected products become unavailable.
Backup Order selected in this Agreement. Allegre will not ship a Backup Order for any
calendar month in which I generate Business Volume equaling or exceeding the amount
I have selected, Allegre is under no obligation to ship any products if the authorized Cancellation Provision
accounts have been overdrawn or closed. I may cancel this agreement for any reason at any time by giving written notice to
Allegre bearing my original signature, printed name, address and Customer Num-
Select Pack Backup Order Substitutions ber. Written cancellations will be effective upon receipt by Allegre. Cancellation notices
must be mailed to: Allegre, 5204 South Procyon Ave, Las Vegas, NV 89118. Faxed or
In the event that any product I have selected on the Select Pack form below becomes email cancellations will not be accepted.
unavailable or if the Business Volume for any products I have selected are reduced, I
authorize Allegre to substitute another product or products of equal or greater value to
ensure that I meet my Business Volume commitment. I further authorize Allegre to Term
charge my account for any price difference for the substituted product(s). If I am not This Preferred Customer Agreement will remain in effect until I: (1) Elect to change or
satisfied with the substituted product(s), I may return it within 30 days for an exchange alter my preferred customer status with Allegre by submitting a new signed Preferred
and authorize Allegre to credit or charge my account for any price difference. Customer Agreement Form, or (2) Cancel this Preferred Customer Agreement pursuant
to the preceding paragraph.
Payment Authorization
I authorize Allegre to withdraw payment for orders I place directly and for my Backup 100% Satisfaction Guarantee
Order from my credit card or bank account as specified on the front of this Agreement. If I am not completely satisfied with any product I purchase from Allegre, Allegre will
Allegre is authorized to withdraw payment equal only to the amount of the price of the replace it without charge or credit my account for the total purchase price of the product,
products that I order, plus applicable sales tax and shipping, or the price of the Backup or upon my written request, refund the total purchase price provided I return the unused
Order I have selected (plus additional amounts for substitute products if selected portion of the product to Allegre, together with a copy of the invoice, within 30 days of
products become unavailable) plus applicable sales tax and shipping. I agree to pay a the date of purchase.
$10.00 service fee in the event a check or charge is dishonored for any reason. After
my account has been charged by my financial institution, I have the right to have the
amount of any erroneous withdrawal immediately deposited to my account by my Renewal Fee for Preferred Customers
financial institution up to 15 days following issuance of my bank statement or 45 days If I have enrolled as a preferred customer, I authorize Allegre to charge my account a
after posting, I will hold Allegre harmless for all special or consequential damages, total of $15.00 on an annual basis for the purpose of automatically renewing my Cus-
whether direct or indirect, resulting from any wrongful debit to my account. tomer Agreement. This $15.00 renewal fee also covers the annual renewal of my Inde-
pendent Representative Agreement.
“Select Pack” The Preferred Customer Backup Order you create with the products you want most!
Customer Name:___________________________________________ SSN:__________________________
Business Volume Commitment (Your Select Pack Business Volume must equal or exceed the commitment level selected below.
(select one) Checking this commitment level entitles you to purchase any combination of Allegre
29 products at Preferred Customer prices on your Select Pack.
You will be sent the Select Pack Backup Order listed below any month that your total Personal Business
Volume does not equal or exceed 29 or 79 Business Volume.
79
Note: You may change the items selected below at any time by contacting Allegre. Changes to your Business
Volume commitment require you to sign and submit a new Preferred Customer Agreement Form.
Select Pack CONTENTS: Specials, discounted products or packs, and promotions are not available as Select Pack items. If a special
or promotion is selected you will receive the product at full price with full Business Volume.
Stock # Qty. Item Description BV Total BV Total BV Total Price
Shipping and handling plus applicable sales tax will be added to your order and reflected on TOTAL BV: TOTAL PRICE:
the printed invoice included
If you have completed the “Select Pack” portion of this form, please fax both sides of this document to Allegre.
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