INDEPENDENT DEALER REGISTRATION FORM

(Please write legibly)

______________________

____________________

____________________

First Name
Middle Name
Last Name
*IMPT please write your name exactly as it should appear on your commission checks (valid ID as ref)
Who introduced you to Human Nature?__________________________________________________________
(Late declaration of upline is only allowed within 30 days upon registration. To update, please send a Letter of Request along with a
newly accomplished Dealer Registration Form with ID, to customer.service@humanheartnature.com .)

Is she/he an existing Human Nature Dealer? _____ If yes, please provide her/his Dealer ID #_______________
Landline Tel. No.: (____) -_______________________ Mobile Phone No.: (____) - ______________________
Email Address: ___________________________

(This email address will be used by you to access your online Dealer Dashboard.)

Home Address: __________________________________________________________ Zipcode: _________

Shipping Address: ________________________________________________________ Zipcode: _________
Birth Date (mm/dd/yy): ____/____/____

Sex (M/F): _____

TIN #: _______________________________________ SSS #: _____________________________________

(Your TIN is needed for us to pay commission to you for your recruits.)

P799 Bestsellers Sample Pack - consists of 12 bestselling products, 10 magalogues & 10 fliers
P1,999 Full Business Development Pack - consists of 27 products, 15 magalogues & 20 fliers
P1,999 Hybrid Business Development Pack - includes the components of the P799 Bestsellers Sample Pack,
and P1,200 worth of products, net of discount (or P1,600 worth of products at SRP).
Once entitled to commissions, how would you like to receive them?

Through Cheque (cross cheque)

Through Credit on Account

(The name that you write in this registration form, shall be the name printed on the cheque. Should you wish to change the mode of release of
your commissions in the future, please contact customer.service@humanheartnature.com, and changes shall apply in the next cycle.)

Mode of payment (cash, credit card, G-Cash. Paypal or bank deposit) _________________________________
(Please note that sample pack prices are exclusive of shipping fee.)

I CERTIFY THAT ALL INFORMATION CONTAINED HEREIN IS TRUE AND CORRECT

Signed: ____________________________________________________ Date: _________________________

PLEASE PROVIDE THE FOLLOWING: Proof of valid ID (with photo)

Upon completion, please email this form to humannaturetrade@yahoo.com or fax to (02) 951-3627
or personally bring to the address below or any Human Nature Branch near you.
_______________________________________________________________________________________________
(For GKI Use Only)

New Dealer ID Number ____________________ Upline Dealer ID Number________________________

Proof of identification verified by ______________________ Interviewed by_____________________
Encoded by ___________________ Comments ___________________________________________
Gandang Kalikasan Inc., 463 Commonwealth Avenue, Quezon City
Tel: 02 224 2224 www.humanheartnature.com

Independent Dealer Agreement

This Agreement, made this ____ day of _______________, year _____ between Gandang Kalikasan, Inc (GKI)
and _____________________________________ (Dealer) WITNESSETH THAT:
GKI agrees that the Dealer may purchase the products of GKI at prices determined by GKI which are below the
retail price, subject to GKIs policies regarding sales, marketing and payment.
The Dealer represents and warrants that all the information he/she has given in this Application Form and
Agreement is true and accurate.
The Dealer agrees:
a) To obtain and maintain all permits and licenses necessary for the continuance of his/her business.
b) To ensure that he/she complies with all applicable laws governing his/her business including payment of any
and all taxes.
c) To pay for all his/her purchases in accordance with the payment policies of GKI without the need for GKI to
demand payment.
d) To hold GKI, its officers and employees free and harmless from any claim, expense, liability, suit or demand
arising from the conduct of his/her business.
e) To immediately inform GKI of any change in his/her personal information given in this Application Form.
f) To sell all products bought from GKI only at the suggested retail prices set by GKI which are current at the
time of sale.
g) Not to sell GKIs products in or to retail stores, supermarkets or other fixed places of business without prior
written permission from GKI.
h) TO STORE THE PRODUCTS AWAY FROM SUNLIGHT AND BELOW 35 DEGREES CENTIGRADE TO
PRESERVE THE QUALITY OF THE PRODUCTS. Failure to do so will cause irreparable damage to the
products such as loss of fragrance, separation or discoloration since the products do not contain chemical
stabilizers or emulsifiers.
i) To never leave the products in the vehicle or any other place that may be subject to heat, and to accept
liability for any change in the quality of products not properly stored in accordance with these directions.
j) To allow use of his/her name for publication from time to time in company documents, merchandising and
other material especially in relation to sales figures and performance tables.
k) To maintain a minimum average purchase level of P800/month net of dealer discount in order to
continuously avail of discounts.
l) That no commission shall be computed and paid if downline is an immediate family member living in the
same address as indicated on the registration form.
GKI and the Dealer agree:
a) That this Dealer Agreement does not make the Dealer an employee or agent of GKI. The Dealer is an
independent businessperson.
b) That this Agreement does not give the Dealer authority to enter into any agreement or contract with any party
by representing himself/herself as an employee or agent of GKI or commit GKI to any contract or agreement
with any third party.
c) That this Agreement does not confer authority to the Dealer to use any of the trademarks or trade names
owned by GKI.
d) That the Dealer will abide by all policies of GKI which may change from time to time.
e) That GKI may change its prices, commission, incentive and credit policies with regard to the Dealer and may
reduce or cancel discounts or other benefits without prior notice.
f) That either party may terminate this Agreement, with or without due cause, at any time upon notice to the
other. Upon termination, all monies owed by Dealer shall become immediately due and payable.
g) That in case of dispute arising directly or indirectly from this Agreement, settlement shall be pursued by
either Arbitration or through the proper courts at the option of GKI.
h) That this Agreement supersedes any prior agreements between GKI and the Dealer.
i)

For:
_________________________
DEALER

__________________________________
GANDANG KALIKASAN, INC.

Gandang Kalikasan Inc., 463 Commonwealth Avenue, Quezon City

Tel: 02 224 2224 www.humanheartnature.com