FAX Cover Sheet

Instructions to sender:  Please print this page and use as your cover sheet for faxing the completed order forms to your Enagic Distributor.  Once faxed, your distributor will review and sign the order form and transmit your order to Enagic for processing. 

FAX TO Number: 815-572-0405 Fax
TO SPONSOR: Robert Hilke Jr
SPONSOR ID: 7129984
Sender's Name: ________________________________
Sender's FAX #: ___________________
Sender's Phone: ___________________
Date: _______________

Re:

Enagic Kangen Water Ionizer Order / Distributor Application
Number of pages:
(with cover)

_______

Please process the attached order for a Kangen Water Ionizer ASAP!

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