Amway Order form

Amway India Enterprises Pvt. Ltd.
Regd. Office : First Floor, Elegance Tower,
Plot No. 8, Non Hierarchical Commercial Centre,
Jasola, New Delhi - 110 025.
Token No.
DISTRIBUTOR ORDER FORM
UPDATED ON 02-08-2015
TM
Please fill in this form before you approach the cashier
(** MANDATORY FIELDS)
** Please present your AMWAY ID Card or Copy of SA 88 ID (Application Form )
** In case of TNA, would you like Amway to place alternate order for you of the same PVs
** The prices are subject to change. Please check the actual price before placing the order.
Yes
No
DATE :
** DISTRIBUTOR NUMBER:
** Mobile No.:
DISTRIBUTOR NAME :
PAYMENT DETAILS
A/R
Bonus Cheque
` 1/- contribution towards AOF {
*PC
Cash
Cr. Card
ITZ Card
DD
}
For * AR, * Bonus Cheque and PC as mode of payment Please verify the same with DCS Before proceeding to cash counter. Personal Cheque (Based on the Eligibility)
ORDER TYPE
Pickup
Single Order
Home Delivery
Group Order
QTY
TOTAL
please fill below the S.N. of ` 500 &
` 1000 Denomination of Notes
1000/- X
500/- X
In case of Home Delivery Please fill the Ship to Address
Name :
100/- X
Ship to Address
50/- X
20/- X
State
10/- X
Pincode
5/- X
** Nearest Landmark
** Land Line / Mobile
TOTAL
PRICES HAVE CHANGED FOR MANY PRODUCTS, MOST PRODUCTS HERE IN ARE
WITH OLD PRICING, COMPLETE NEW PRICE LIST AVAILABLE WITH DCS DESK
SKU Nos. Qty.
Description
PV
DAP
248392
248390
Numberless Application Pad - 20
Customer Receipt Pad
0.00
0.00
100.00
25.00
241553
250481
Olive Pomace Oil
Amway Polybags
1.32
0.00
458.00
5.00
254612
254611
254610
102578
5985
119675
8086
100260
102745
89
100066
100076
100070
105074
100352
114115
104144
8058
242462
8617
8669
100346
4302
8085
102046
All Plant Protein 1 kg Pack
All Plant Protein 500gms Pack
All Plant Protein 200gms Pack
Nutrilite Protein with Green Tea - 500gms
Siberian Ginseng - 100 Tabs
Triple Guard Echinacea - 60 Tabs
Glucosamine HCL - 120 Tabs
Nutrilite Daily - 60 Tabs
Nutrilite Daily - 120 Tabs LM
Nutrilite Bone Health with IPV - 60 Tabs
Nutrilite Salmon Omega 3 - 60 Tabs
Nutrilite Garlic Heart Care - 60 Tabs
Nutrilite CH Balance - 60 Soft Gels
Nutrilite Fiber - 200gms
Nutrilite Milk Thistle
Nutrilite Coenzyme Q 10
Nutrilite Vision Health - Lutein
Nutrilite Multicarotene
Kids Chocolate Drink - 500 gms
Kids Chewable Vitamin C - 100 Tabs
Kids Chewable Iron - 100 Tabs
Kids Chewable Conc. Fruit & Veg - 60 Tabs
Nut. Kids Chewable Cal. Mag. - 100 Tabs
Nutrilite Black Cohosh & Soy
Nutrilite Tri- Iron Folic
38.66
22.96
10.95
21.88
28.08
16.39
28.84
12.59
21.45
18.57
13.95
7.88
28.75
9.51
15.96
10.29
20.76
13.37
10.38
16.14
7.01
16.50
8.61
11.88
9.11
3684.00
2188.00
1044.00
2086.00
2676.00
1562.00
2749.00
1200.00
2044.00
1769.00
1329.00
751.00
2740.00
906.00
1521.00
980.00
1979.00
1274.00
990.00
1539.00
669.00
1530.00
821.00
1132.00
868.00
NUTRITION & WELLNESS
Total
Value
SKU Nos. Qty.
Description
PV
DAP
Total
Value
HOME CARE
1
116511
116515
110488
116512
116516
8393
109859
112532
116514
116513
4111
8095
8945
100949
3417
8967
7506
110403
LOC Multipurpose 1 L
LOC Multipurpose 500ml
LOC Sachets
Dish Drop 1 L
Dish Drop 500 ml
Dish Drop Sachets
Zoom 500ml
LOC Glass Cleaner 500 ml
SA 8 Gelzyme 1 Litre
SA 8 Gelzyme 500 ml
SA 8 Delicate 500 ml
Car Wash 500 ml
Leather & Vinyl Cleaner 500ml
SA 8 Prewash Liquid 500ml
Apsa 80 - 500 ml
Apsa 80 - 1 litre
Silicone Glaze 500ml
Pursue Disinfectant 500 ml
SA 8 Prewash Spray
4.75
2.88
0.07
6.21
3.55
0.07
2.68
2.88
8.28
4.86
4.29
2.75
3.33
4.14
6.79
11.38
5.34
2.78
9.62
453.00
275.00
6.00
592.00
339.00
6.00
256.00
275.00
789.00
463.00
409.00
262.00
317.00
395.00
647.00
1085.00
509.00
265.00
916.00
TEAR OFF
PAYMENT DETAILS
PAYMENT MODE :
ORDER No.
Receipt (To be filled in by Cashier )
DATE
TOTAL AMOUNT
CASH CCARD DD BC AR PC ITZ
CASHIER’S SIGNATURE
Website : www.amway.in / Call Centre : 080 - 3941 6600 / Mobile Website / http : // m.amway.in
SKU Nos. Qty.
Description
PV
DAP
1.40
1.40
1.40
1.40
1.40
4.24
1.36
4.24
1.36
1.20
2.07
1.39
1.16
1.47
4,24
1.45
2.17
2.97
3.71
2.64
3.22
15.29
6.83
3.13
4.42
4.42
4.42
4.42
4.42
2.39
2.39
120.00
120.00
120.00
120.00
120.00
404.00
129.00
404.00
129.00
114.00
197.00
133.00
110.00
141.00
404.00
138.00
207.00
284.00
353.00
252.00
307.00
1458.00
651.00
298.00
421.00
421.00
421.00
421.00
421.00
229.00
229.00
73.10
38.00
24.04
15.38
24.04
13.08
13.08
17.30
13.08
13.08
17.30
7.88
13.95
13.95
23.55
23.55
38.46
38.46
5.76
6.72
6.72
5.76
3.84
3.84
3.36
3.36
5.76
5.76
5.76
5.76
2.78
4.24
3.26
3.17
3.26
4.80
4.80
3.80
3.93
6.29
3.80
6966.00
3621.00
2291.00
1466.00
2291.00
1246.00
1246.00
1649.00
1246.00
1246.00
1649.00
751.00
1329.00
1329.00
2245.00
2245.00
3666.00
3666.00
549.00
641.00
641.00
549.00
366.00
366.00
320.00
320.00
549.00
549.00
549.00
549.00
264.00
404.00
311.00
303.00
311.00
458.00
458.00
362.00
375.00
600.00
362.00
Total
Value
PERSONAL CARE
246163
246162
246160
246161
246159
2183
100661
6826
100660
265002
215358
216916
265003
266404
2184
200760
100950
254282
254283
254287
254288
110686
110674
115776
246164
246165
246166
246167
246168
250320
250319
Satn. Adv. 2 in 1 Shampoo & Cond. Sach 20
Satn. Adv. Dandruff Control Cond Shampoo Sach 20
Satn. Gloss Rep Cond. 4ml
Satn. Hair Fall Control 4ml
Satn. Glossy Repair 4ml
G & H Lotion 250 ml
G & H Lotion 60 ml
G & H Body Shampoo 250 ml
G & H Body Shampoo 60 ml
Advance Sr. toothbrush Pack of 3
Persona Talcum Powder - 350 gms
Persona Talcum Powder - 200 gms
Advance Jr. toothbrush
Persona Bar Soap - 3 pcs.
Nature Shower Creme Hand Soap - 250 ml
Glister Multi - Action TP - 100 gms
Sweet Shot Mint
Dynamite Shaving Foam
Dynamite After Shave Splash
Dynamite Face Wash (for Men)
Dynamite Whitening Cream (for Men)
Satn. Scalp Tonic 80 ml
Satn. Rvtl SNG Hair Masq 240G
Satn. Styling Gel 150gm
Satn. Adv 2 in 1 Shampoo & Cond.
Satn. Glossy Repair 250ml
Satn. Glossy Repair Cond. 250ml
Satn. Hair Fall Control 250ml
Satn. Anti Dandruff Shampoo
Attitude Deodrant ( for Women 150ml)
Dynamite Deodrant ( for Men 150ml)
109709
107998
107992
111643
100240
104126
104127
104128
104129
104130
104131
105531
106399
106401
106136
106147
116694
116695
266127
259639
259640
248342
266129
248344
252915
252916
258025
258026
258023
258024
244749
244742
244750
244752
244751
252920
252913
244743
244744
244745
244746
Anti Wrinkle Firming Seru
Artistry Renewal Peel
Alpha Hydroxy Syrum Plus
Artistry Creamy Massage
Skin Refinishing Lotion
Ess Hydrating Cleanser Dry
Ess Hydrating Toner - Dry
Ess Hydrating Lotion - Dry
Ess Balancing Cleanser - Oily
Ess Balancing Toner - Oily
Ess Balancing Lotion - Oily
Replenishing Daily Eye Cream
Polishing Scrub
Moisture Intense Masque
Hydrating Foundation - Cameo Fair
Hydrating Foundation - Soleil (Medium)
Art. Loose Powder - Light
Art. Loose Powder - Medium
Mascara
Compact Powder - Light
Compact Powder - Medium
Eye Liner Black
Eye Liner Pencil Kajal
Eye Pencil Kajal Coal
Eye Pencil Pearl Glam
Eye Pencil Golden Shimmer
Eye Pencil Twlight Blue & Lil
Eye Pencil Szlng Silver & Rich
Lip Pencil Rustic Sheen
Lip Pencil Vintage Wine
Attitude Face Wash
Attitude Sun Screen
Attitude Face Masque
Attitude Hand & Body Cream
Attitude Foot Cream
Attitude Eyeshadow Deep Truth
Attitude Blushers Dazling Sheen
Attitude Cleanser Dry
Attitude Toner Dry
Attitude Moisturizer Dry
Attitude Cleanser Oily
BEAUTY
SKU Nos. Qty.
Description
244747
244748
265595
265596
265597
265598
265599
258017
247168
253936
253937
265279
265280
265281
265282
265283
265284
253938
265285
265286
265287
265288
265291
265292
266125
266126
256305
256306
258027
258028
258029
258030
113803
113804
113807
113808
113809
113810
116413
116409
Attitude Toner Oily
Attitude Moisturizer Oily
Attitude Be Bright Face Wash
Attitude Be Bright Face Masque
Attitude Be Bright Face Scrub
Attitude Be Bright Night Cream
Attitude Be Bright Day Cream
Lipstick Berry Rose
Lipstick Hazel Crush
Lipstick Dream Garnet
Lipstick Satin Peach
Lipstick Deep Raspber
Lipstick Wine Lustre
Lipstick Soft Pink
Lipstick Mad About
Lipstick Flaming Peac
Lipstick Gold Touch
Attitude Ne Pearl Shimmer
NailPaints Lilac Blos
NailPaints Orane Pass
NailPaints Pink State
NailPaints Precious P
Eye Shadow
Blusher
Compact Light
Compact Medium
Attitude Lip Gloss Luscious Plum
Attitude Lip Gloss Midnite Mist
Attitude Lip Gloss Bronje Glam
Attitude Lip Gloss Wine Fusion
Attitude Lip Gloss Natural Peach
Attitude Lip Gloss Strawberry Pink
Artistry YX Protecting Lotion
Artistry YX Enriching Lotion
Artistry YX Protecting Cream
Artistry YX Enriching Cream
Artistry YX Serum Concentrate
Artistry YX Enriching Eye Cream
Artistry IDL Rdianc Spot Corre
Artistry IDL Rdianc Ilumntng E
265004
246174
230415
254284
254285
254286
Persona Classic Toothbrush (Pack 2)
Persona Coconut Oil
Persona Amla Hair Oil 200mll
Dynamite Hair Cream 150 gms Tube
Dynamite Shaving Cream 70 gms (2)
Dynamite Razors (Pack of 10)
868
1605
9061
204239
1065
110487
1404
250674
250673
Personal Care Pump Disp.
Home Care Pump Disp. 1 Litre
Home Care Pump Disp. 500 ml
Pour & Measure Cap
Pistol Grip Spray
Squeeze Bottle
Turret Top Cap
Body Sponge (Ivory)
Body Sponge (Peach)
PV
DAP
3.93
6.29
3.03
4.32
4.32
5.28
5.28
3.03
2.64
2.64
2.64
3.55
3.55
3.55
3.55
3.55
3.55
1.36
1.92
1.92
1.92
1.92
5.76
5.76
6.72
6.72
3.45
3.45
3.51
3.51
3.51
3.51
37.03
37.03
37.03
37.03
41.83
25.00
27.50
43.28
375.00
600.00
289.00
412.00
412.00
503.00
503.00
288.00
252.00
252.00
252.00
338.00
338.00
338.00
338.00
338.00
338.00
130.00
183.00
183.00
183.00
183.00
549.00
549.00
641.00
641.00
329.00
329.00
334.00
334.00
334.00
334.00
3529.00
3529.00
3529.00
3529.00
3986.00
2383.00
2621.00
4124.00
0.50
1.00
0.42
0.47
0.53
1.33
47.00
173.00
73.00
82.00
91.00
153.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
21.00
46.00
46.00
45.00
27.00
19.00
9.00
25.00
25.00
Total
Value
GREAT VALUE PRODUCT
SALES AID
Distributor’s Signature
TEAR OFF
Introducing New Payment Mode !!!
AMWAY ITZ CASH CARD Collect your Card Today !
C One Time Activation Charge of `10/- plus Service tax C So...... STOP Carrying Cash,
C STOP Writing Currency series on the order form
C No Subscription Fee / No Renewal Fee
PAY BY CHALLAN (PBC)
Only 2 Simple Steps to be followed
C Place your order at Amway Call Centre 080 - 3941 6600 Request for PBC Option
C Deposit Cash within 2 working days at any of the AXIS/ IDBI / YES / ING VYSA Bank & get Amway Products
Delivered at your door step or to Ship Address Deposit Slip can be downloaded from Amway Website.
For Further Details Please Contact the Customer Service Desk