Alliance in Motion Global. Inc.

Unit 301 & 320 3/F AIC-Burgundy Empire Tower, ADB Ave, cor. Sapphire & Garnet Sts. Ortigas Centerm Pasig City, Philippines

www.allianceinmotion.com

DISTRIBUTOR APPLICATION FORM

Personal Information
LAST NAME Address Birthdate MM Home Telephone No. E-mail Address Beneficiary Age Relationship Age DD YYYY Mobile No. Status USER NAME FIRST NAME MIDDLE NAME

GLOBAL PACK SALES INFORMATION

Sponsors Name Placement Name Position Signature of Sponsor L R Signature of Appllicant Sponsor ID No. Placement ID No.

PAYMENT INFORMATION
Check Amount Signature For and behalf of Date Cash

GLOBAL PACK PACKAGE

C24 / 7 Business Kit VCD

Brochure

DAF

Endorsement Letter Scholarship

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SINGLE X MARRIED SEPARATED DIVORCED