ONLINE ENROLMENT

Sponsor Details

Introducer ID
e.g.(EMYXXXXXXX)

I do not have an Introducer/Sponsor. I understand that an ETERNER Distributor will be assigned to me as my upline sponsor to assist me in providing product information and helping me in my ETERNER transactions.

leave empty if you don't have any referral

Applicant Details

Full Name*

IC/passport No*

Upload IC/ Passport*

Age*

Email*

Country*

Mobile*
e.g.(195679875)

Race

Gender

Applicant Information

Kindly state your relationship with your direct upline.
Do you have other distributor account (individual/business entity) with ETERNER? If yes, kindly state down the name of the account holder.
Do you have any distributor account with other direct selling company? If yes, kindly state down the name of the company.
Do you have any working experience in Direct Selling?
Kindly state your education level.
Kindly state your working experience.
Kindly state your preferred language for communication.

I hereby confirm all the information provided are accurate and up-to-date. I also understand that any willful dishonest may render for refusal of this application and termination of distributorship. By clicking submit, I confirm that (i) accept the Terms and Conditions, and (ii) consent to the processing of my personal data by ETERNER in accordance with the Personal Data Protection Notice.

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