_______Use a check mark

_______ Fill in all information completely

_______Sign the Application

_______Complete Business Entity Disclosure Form (if necessary)

_______Consult the Order guide for pricing and item numbers

_______Complete a Product and Sales Aid Form for your Distributor Kit. A Sample form showing exactly how to fill out an order form is available from Stimulife International, Inc. Fax on Demand at 887-699-8946.

_______Pay the $29.50 Distributor Kit charge, plus applicable tax and shipping, by credit card or check. If you plan to fax your application, the fee can be paid by credit card only.

_______When faxing your Application and Order Form, you may, at that time, also order up to a maximum of $300.00 in product. However, you are not required to order anything but your Distributor Kit to become a distributor. There are no order limitations if you are mailing in your Application and Order Form.

NOTE: After faxing in your application, you must send in your signed original Application within 10 days.