By electronically “signing” below and clicking on the “Agree and Submit” button, you:
  • Certify that you are of legal age (the age of majority) in the state in which you reside;
  • Verify that you have carefully read and agree to abide by all of the terms set forth in the Policies and Procedures, Purchase Agreement, Compensation Plan Overview, Compensation Plan Agreement, 60-Day Money-Back Guarantee & RMA Instructions;
  • Certify that the Social Security Number, Employee Identification Number or Government ID entered is your correct taxpayer identification number; and
  • Further certify that you have not been an AVACEN distributor, or a partner, shareholder, or principal of any entity having an AVACEN business within the past six months. In the event your Application is accepted by AVACEN, you will have the right to terminate the Agreement at any time, with or without reason. Such termination must be in writing.
*IA or IR (Distributor) ID number:
*First and Last Name:

(Example/Ejemplo/Exemple: Neha Aggarwal)

*Email Address:

(Example/Ejemplo/Exemple: nehaa@domain.com)

*Confirm Email Address:

(same as above)

*Digital Signature

Important: Works best when browser is set to 100% zoom and display settings are at 100%.

If you have trouble signing, please continue to section below:

*Please type your initials and today's date:

If you cannot digitally sign, along with your initials and date, please also type in: "/s/full name"

For example, your name is: David Johnson, you will type:

DJ, today's date, and /s/David Johnson

Today's Date
12:11 am 15 December 2017 PST