Sponsor ID :*
Name :
Name :*
Mobile Phone :*
Pan Number :
Address :*
Amount :*
Payment Mode :
Bank Name:
Branch Name:
Cheque / DD No:
Cheque Date:
Company Account:
Transaction No. :
Transaction Date. :
Wallet Name:
Transaction No. :
Transaction Date. :


I verify that I have read and agree to the Policies and Procedures, the terms and conditions set forth in the Brand Partner Agreement, and the Electronic Signature Agreement. I further verify that I am free and clear of any contractual obligation with any other direct sales company that would prohibit me from joining and participating in Moonlite now or at any time in the future and have read and agree to the terms and conditions that govern the usage of the Team Office suite (VCloud) as outlined in the Privacy Policy.
I have read and agree to the Cancellation & Refund Policy. I may cancel the purchase and/or request by emailing or contacting customer service.