Amway India Enterprises Pvt Ltd

Regd. Office : First Floor, Elegance Tower,

Plot No. 8, Non Hierarchical Commercial Centre,
Jasola, New Delhi - 110 025.
DISTRIBUTOR NUMBER

DISTRIBUTOR NAME

DISTRIBUTOR ORDER FORM

UPDATED ON 01/06/2011
Pick Up Order

Location :

Home Delivery Order

SKU Nos. Qty.

PV

DESCRIPTION

236691
9788

Literature Kit - English

Number Less Application Pad

107766
100141
100142
8086
5985
100309
100260
102745
100997
101153
101154
100863
242462
103902
109780
100346
8617
4302
8669
242259
89
100066
100076
212132
217040
100070
105074
101419
102992
109960

NUTRITION & WELLNESS

Nut. Protein Family pack 1Kg
Nutrilite Protein 500 gms
Nutrilite Protein 200 gms
Glucosamine HCL 120 Tabs.
Siberian Ginseng 100 Tabs
Triple Guard Echinacea 60 Tabs.
Nut. Daily 60 Tabs.
Nut. Daily 120 Tabs
Nut. Iron Folic - 90 Tabs.
Nut. Bio C - 100 Tabs.
Nut. Parselenium E 30 Tabs.
Nut. Kids Chewable 60 Tabs.
Nut. kids Chocolate
Nut. Kids Banana Drink 500 gms
Nut. Kids Mango Drink
Nut.Kids Chewable CFV - 60Tab
Nut.Kids Chewable Vitamin C -100 Tab
Nut.Kids Chewable Cal Mag -100 Tab
Nut.Kids Chewable Iron -100 Tab
Nut.Kids Drink Mixed Fruit
Nut. Bone Health with IVP 60 Tabs.
Nut. Salmon Omega 3 - 60 Tbs
Nut. Garlic Heart Care 60 Tabs.
Positirim Choco Drink Mix
Positirim Vanilla Low Fat Drink
Nutrilite CH Balance 60 Tab
Nut. Fiber 200 gms
Natural B 100 Tab
Conc. Fruits & Veg 60 Tab
Nutrilite Calmag - D 90 tab

DAP*

0
0

995
100

37.06
22.01
10.51
33.01
32.55
17.61
14.66
24.83
9.3
13.93
13.93
13.93
11.50
11.00
11.50
18.35
18.35
9.78
7.95
11.50
28.38
15.28
22.63
22.63
32.42
10.51
9.41
19.45
7.58

2524
1499
716
2249
2217
1200
999
1691
633
949
949
949
783
749
783
1249
1249
665
541
783
1933
1041
541
1541
1541
2208
716
641
1324
516

4.83
2.91
0.06
6.35
3.73
0.06
2.91
2.91
8.08
4.75
3.13
4.75
3.00
3.61
5.70
4.63
5.25
8.56

329
199
5
433
254
5
199
199
550
324
213
324
204
246
388
316
358
583

1.20
1.20
1.20
4.63

100
100
100
316

7.95

Total
Value

L.O.C. High Suds - 1 lt

L.O.C. High Suds - 500 ml
Loc Sachets
Dish Drop 1 Litre
Dish Drop 500 ml
Dish Drop Sachet 8 ml
See Spray 500 ml
Zoom 500 ml
SA-8 Gelzyme 1 Litre
SA-8 Gelzyme 500 ml
Pursue Disinfactant Cleaner500ml
SA-8 Delicate 500 ml
Car Wash 500 ml
Leather & Vinyl Cleaner 500 ml
Silicone Glaze 500 ml
Pre Wash Liquid 500 ml
Apsa 80 500 ml
Apsa 80 - 1 Ltr.

Sat. Adv. 2 in 1 Shamp & Cond Sachets 20

Sat Adv Dandruff Control Sachets 20
Sat Detangler Sachets 20
Sat Adv 2 in 1 Shampoo & Conditioner

Date :

DESCRIPTION

PV

DAP*

Sat Adv Mois Detangler Conditioner

Sat Adv Dandruff Control Conditioner Shampoo
Sat Hair Rejuv Masque
G & H Lotion 250 ml
G & H Lotion 60 ml
G & H Body Shampoo 250ml
G & H Body Shampoo 60ml
Nature Shower Creamy hand soap 250ml
Advance Jr. Tooth Brush ( Pack of 4 )
Persona Bar Soap ( Pack of 3 )
Persona Talcum Powder 200 gms
Persona Talcum Powder 350 gms
Glister Toothpaste -100Gms
Dynamite Foam
Dynamite Moisturiser
Dynamite Splash
Dynamite Deodorant Men
Attitude Deo Women
Sweetshot Mint

4.63
4.63
5.25
4.63
1.45
4.63
1.45
4.63
1.13
1.59
1.51
2.26
1.58
3.41
2.03
4.15
2.68
2.68
2.43

316
316
358
316
99
316
99
316
77
108
103
154
108
233
138
283
183
183
166

1.00
1.63
0.45
0.55
0.58
0.73

68
147
61
75
80
99

28.13
9.17
25.02
14.06
14.06
18.41
27.52
27.52
27.52
27.52
28.13
14.07
14.07
16.50
14.07
14.07
16.50
24.46
24.46
24.46
2.92
4.51
3.48
3.48
3.48
4.14
4.14
6.47
4.14
4.14
6.47

1916
624
1708
958
958
1249
1874
1874
1874
1874
1916
958
958
1124
958
958
1124
1666
1666
1666
199
308
238
238
238
283
283
441
283
283
441

Total
Value

GREAT VALUE PRODUCTS

230295
231244
230415
231227
212737
246174

Persona classic Toothbrush ( Pack of 4 )

Dynamite Razors ( Pack of 10 Razors )
Persona AMLA Hair Oil ( 200 ml )
Dynamite Hair Cream ( 150 g tube )
Dynamite Shaving Cream 70 g ( Pack of 2 )
Persona Coconut Oil 500ml

ARTISTRY & ATTITUDE

100240
105531
104020
106399
106401
100183
101821
101822
101823
101824
107992
104126
104127
104128
104129
104130
104131
106136
106147
106150
234246
234248
234249
234250
234293
234193
234209
234210
234214
234215
234245

PERSONAL CARE
215434
215435
215436
5030

SKU Nos. Qty.

5050
5060
5070
2183
100661
6826
100660
2184
241041
246173
216916
215358
200760
212738
212739
212740
230414
230396
100950

HOME CARE

8156
8392
137
228
8391
138
3941
8393
0033
101158
7506
4110
4111
8095
8967
8945
100949
3417

TM

1. In case of TNA, would you like Amway to place alternate order for you of the same PVs Yes
2. The above prices are subject to change. Please check the actual price before placing the order.

Skin Refinishing Lotion

Replenishing Eye Cream
Pure Whitening Essence
Polishing Scrub - A8 ESS
Moisture Intense Masque
Artistry Creamy Massage
Time Defiance Day Cream
Time Defiance Day Lotion
Time Defiance Night Time Cream
Time Defiance Night Time Lotion
Alpha Hydroxy Serum Plus
ESS Hydrating Cleanser
ESS Hydrating Toner
Ess Hydrating Lotion
ESS Balancing Cleanser
ESS Balancing Toner
Ess Balancing Lotion
Foundation - CAMEO
Foundation - SOLEIL
Foundation - GOLDEN
Attitude Face Wash
Attitude Sun Screen
Attitude Face Masque
Attitude Hand & Body Cream
Attitude Foot Cream
Normal to Oily Cleanser
Normal to Oily Toner
Normal to Oily Moisturizer
Normal to Dry Cleanser
Normal to Dry Toner
Normal to Dry Moisturizer

No
Please put the Ship to Address on the reverse side of the Order Form)

PAYMENT DETAILS
By DD/Cheque_______________________(DD/Cheque No._______________Dt :_________________By Cash _______________
Bank________________________ Payable at ______________________________________________
Credit Card No. ____________________________________________________
Card Holder's Name
Expiry Date

(Only Master / Visa Card)

Distributor's Signature

Please fill in this form all relevant information before you approach the cashier
Please present your Amway ID card or Copy of SA 88 ID (Application Form)
Trademarks of Amway Corp. Ada. MI U.S.A. All rights reversed. Printed in India.
P.T.O.

TEAR OFF

Receipt (To be filled in by Cashier)

ORDER NO.

DATE

AMOUNT

CASH / CC / DD / BC / AR / PC
Cashier's Signature

SKU Nos. Qty.

DESCRIPTION

PV

DAP*

3.42
3.42
3.42
4.83
4.28
3.42
2.77
2.77
2.77
2.92
2.92
2.92
2.92
2.92
2.92
1.58
1.58
1.58
1.58
1.33
5.51
5.51

233
233
233
329
292
233
188
188
188
199
199
199
199
199
199
108
108
108
108
91
375
375

Total
SKU Nos. Qty.
Value

Eye Pencil Deep Purple

Eye Pencil Cobalt Blue
Eye Pencil Dark Brown
Eye Liner
Mascara
Kajal-coal
Lip Liner Chocolat Brown
Lip Liner Forever Mauve
Lip Liner Gorgeous Red
Lipstick Rustic Spice
Lipstick Smoky Browne
Lipstick Pink frost
Lipstick Mystic Wine
Lipstick Silky Mauve
Lipstick Fiery Red
Nail Enamel Wine Berry
Nail Enamel Peach Spark
Nail Enamel Laven Rain
Nail Enamel Ginger Fizz
Tester Pack
Attitude Eye Shadows
Attitude Blushers

PV

DAP*

Total
Value

SALES AID

ATTITUDE COLOUR RANGE

239112
239111
239113
234294
234073
233889
233890
233891
233892
241615
241616
241617
241618
241619
241620
241621
241622
241623
241624
241625
241701
241702

DESCRIPTION

Personal Care Pump Disp

Home Care Pump Disp 1 lts
Home Care Pump Disp 500 ml
Pour & Measure Cap
Pistrol Grip Sprayer
Squeeze Bottle
Turtet Top Closure
Body Sponge ( Ivory )
Body Sponge ( Peach )

868
1605
9061
204239
1065
1075
1404
9137
9198

1000/-

500/-

100/-

50/-

20/-

10/-

5/-

Coin

21
46
46
45
27
18
9
38
38

Total
Distributor No.......................................................................................................................
Ship to Address
Name :
Address

Nearest Landmark
District

Land Line Number

City

Mobile Number

Pincode
State
If you are paying by Cash and of Rs. 500 & Rs. 1000 Denomination, please fill below the S.N. # of Notes

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16

17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Re.1/- contribution towards AOF

website: www.amway.in / Regional Call Center - South: 044-3941 6600 / Toll Free : 1800 3000 6600 / Mobile website - http://m.amway.in