Black Hills Health Products
APPLICATION TYPE:
    NEW
    UPDATE
 
Member Application and Agreement Form

5620 Homer Davis Rd  Shepherd, MT 59079***Now under new Ownership & Management ***(formerly known as : FMG/The Health Nuts)
(406) 373-0141 Local Home Office Number  Hours 8:00am to 5:00 pm Mountain time M-F 1-(888)-383-4056 Toll Free Number
(406) 373-0148 Fax Number

New Member SS # or Fed ID #
 		 BHHP#
(office use)
 
Sponsor Name:
 
Sponsors BHHPI #
 		 Sponsor's Phone #
 
Check one: Individual DBA Corporation
Trust Other 		Call your Sponsor if you need assistance with this form!
Applicant's Name (Last, First, Middle Initial)
 		 Date of Application
 
Payment Method Billing Address:
Street Address
 
City State Zip Code
Permanent Shipping Address (if different from above:)
Street Address
 
City
 		 State
 		 Zip Code
 
Home Phone
 		 Cell Phone
 		 Work Phone
 		 E-Mail Address
 
 
Please select ONE of the following options, and consult your sponsor for assistance to be sure you understand your choices:
OPTION 1: Auto-Purchase and Auto-Payment
As a convenience to me, I instruct and authorize Black Hills Health Products, Inc. to send me future
product purchases each month, around the 15th, the following product(s) ________________________
__________________________________________________________________________________, which will qualify me for any commissions earned. Please
Please deduct my Auto ship purchase(s) + shipping and handling from one of the following payment methods. 

one
  Charge my credit card to purchase products for the next month, ACCT.#______________________ exp.________

  Draft my bank account to purchase products for the next month, ACCT.#__________________________ Routing#.__________________________
 It is my responsibility to notify the home office of any updates or changes to this information!
Completed STANDING ORDER must be submitted with this application!
OR
OPTION 2: Manual Purchase
I understand I will be responsible for ordering and paying for all my products each I place an order.
Please send me all my commissions I may have earned, if I was qualified. I understand I will not receive a commission check if I fail to make a qualifying purchase in the same month I have down line ordering in.
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Applicant signature (required)		                          
Date
I hereby apply to become a member of Black Hills Health Products, Inc.. I have read and understand the terms and agreements. I have read and understand the Policy and Procedures. I have read and understand the compensation plan.  
By signing below, I certify that I am of legal age in the state I reside. I understand I have the right to terminate, with or without reason, by submitting written notice to Black Hills Health Products, Inc. home office. Membership is automatic pursuant to my 1st purchase of products payable by VISA, MasterCard, Discover, or American Express Credit cards, personal/business check, cashier's check, money order,  bank draft. or cash.
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Applicant signature (required)		                          
Date
This form must be filled out, signed & returned by fax or mail to our home office!
 

 Welcome Company Information

Colon Health   Colostrum   Mineral Water   Acid Wastes   One of a Kind Anti-Oxidant

Enzymes Q&A  Oatmeal Test

Testimonials   Comp Plan  Application and Agreement

Products  Tinctures in a Bottle

 Printable Order Form

Secure On Line Order

 
Black Hills Health Products
 
5620 Homer Davis Rd.
Shepherd, MT 59079

Toll free (888) 383-4056
Office(406) 373-0141
 Fax (406 373-0148
click here to e-mail