http://reviews.nerium.com Save $30–115 per order as a Preferred Customer! Take advantage of our 3UR Free program. If you have at least three Preferred Customers in one calendar month whose product order in the Auto-Delivery Order (ADO) program totals or exceeds the amount of your Auto Delivery Order, your next month’s order is FREE!

1. ©2015 Nerium International™
, LLC. 4006 Belt Line Road #100 Addison, TX 75001 Tel: 855-463-7486 Fax to: 214-390-9988 neriumsupport.com All Rights Reserved. R0215
United States Preferred Customer Application
Purchase Product
Quantity Description Auto-Delivery Preferred Customer Price: Total
Nerium Age-Defying Night Cream $80/Bottle
Nerium Night & Day Combo Pack $120/Pack of Day and Night Creams
Nerium Firming Body Contour Cream $80/Tube
Ultimate Combo Pack
$160/Pack of Day and Night Creams
plus Body Contour Cream
I would like to become a Nerium International™
Preferred Customer and receive the product order specified
above every month at the discounted price indicated above. Shipping and handling and applicable sales
tax will be added to my total order at the time it is processed.
Enroll me in the optional Auto-Delivery Order program. I understand and agree that my Auto-Delivery Order will be
processed and shipped monthly, starting next month. I understand that if my initial enrollment is processed after
the 23rd of the current month, my next Auto-Delivery Order will be processed on the 23rd of the next calendar
month. The payment method used for my initial enrollment will be used for my Auto-Delivery Order.
Signature:
Who Is Sharing Nerium With You?
Nerium Brand Partner ID or Username
Name (First, Last) City ST
Personal Information
Name (Last, First, Middle) Date of Birth (mm/dd/yyyy)
Business Name (if applicable)
Shipping Address
City ST Zip Code Country
Email Phone Number cell home
Referral Website Information
Choose a name for your branded Nerium referral website
Example: www.yourname.neriumproducts.com
Option 1
Option 2
This will also be your username for logging in to your personal account.
Retail customers will use your referral website to place orders.
Password (Must consist of letters and numbers only and be
4–15 characters in length.)
Take advantage of our 3UR Free program. If you have
at least three Preferred Customers in one calendar
month whose product order in the Auto-Delivery
Order (ADO) program totals or exceeds the amount
of your Auto Delivery Order, your next month’s order
is FREE!
Payment Method
Visa MasterCard Discover Card Number Exp. (mm/yyyy) CVV
Billing Address City ST Zip Code
Name on Card Signature of Cardholder (required)
I authorize Nerium International to charge the above named account for the purchase option selected. I understand that Nerium International will apply applicable taxes and shipping and handling charges to my order. An Auto-Delivery Order
is included in this purchase option. I authorize Nerium International to ship/charge for these products monthly. Cancellation must be submitted in writing at least five (5) business days prior to the Auto-Delivery billing cycle date. I understand that
all financial transactions are in U.S. dollars. I hereby attest that I am 18 years of age or older and have the legal capacity to enter into binding agreements. My signature below indicates that I have carefully read and understand the
Terms of Agreement, Privacy Policy and Refund Policy, and I am willing to accept the terms and conditions herein.
Preferred Customer Signature: Date:
Save $30–115 per order as a Preferred Customer!
American Express
To enroll via email, please scan or take a photo of your application and send to enrollments@nerium.com.
Nerium Products
Our products contain the
most effective age-defying
ingredients available, chosen
for both their individual and
synergistic benefits. These
premium ingredients are
blended at optimum levels
to nourish your skin and
provide real results.
X
2795720
Felipe Huicochea Dallas TX

2. ©2015 Nerium International™
, LLC. 4006 Belt Line Road #100 Addison, TX 75001 Tel: 855-463-7486 Fax to: 214-390-9988 neriumsupport.com All Rights Reserved. R0215
Nerium Products
Our products contain the
most effective age-defying
ingredients available, chosen
for both their individual and
synergistic benefits. These
premium ingredients are
blended at optimum levels
to nourish your skin and
provide real results.
Order Product
Quantity Description Auto-Delivery Preferred Customer Price: Total
Nerium Age-Defying Night Cream $110/Bottle
Nerium Night & Day Combo Pack $165/Pack of Day and Night Creams
Nerium Firming Body Contour Cream $110/Tube
Nerium Ultimate Combo Pack
$275/Pack of Day and Night Creams
plus Body Contour Cream
Please send me the product(s) indicated above. Shipping & handling and applicable sales tax will be added to my total
order at the time it is processed. I hereby attest that I am 18 years of age or older and have the legal capacity to enter
into binding agreements.
Signature: Date:
Who Is Sharing Nerium With You?
Nerium Brand Partner ID Number or Username
Name (First, Last) City ST
Personal Information
Name (Last, First, Middle) Date of Birth (mm/dd/yyyy)
Business Name (if applicable)
Shipping Address
City ST Zip Code Country
Email Phone Number cell home
United States Retail Customer Order Form
How to Reorder
When your order is processed, you will receive a confirmation email from Nerium International™
. It will include information about how to reorder products
online from your Nerium personal account. Please save the confirmation email, as it will include your personal log-in information and the website address
to reorder. Please note that you will receive a temporary password that may be changed the first time you log in to your Nerium Personal Account.
Retail Customer Return Policy
NeriumInternational is sure you will be happy with your order. However, if for any reason you wish to return your product, we gladly offer a 30-day, money-back satisfaction guarantee to all retail
customers. If a retail customer is dissatisfied with any product for any reason, you may return the item in its original packaging, along with the original invoice, to Nerium International within 30
days of the purchase for a full refund of the purchase price minus shipping. Customer is responsible for cost of return freight. Non-accepted delivery charges will be debited to the customer’s
account for refusing product.
If the product was purchased directly from an Independent Brand Partner, please contact them for a refund. You will need to return the product and original invoice to the Brand Partner, who will
refund the product purchase price. The Brand Partner will then return the product to Nerium International for a replacement product.
If the product was purchased from a Brand Partner website, please contact the Nerium International Support Department.
In order to facilitate the return process, the retail customer is required to contact Nerium International to obtain a Return Merchandise Authorization Number. This number must be written on the
outside of the shipping box. If a package is returned without a Return Merchandise Authorization Number, the refund may be delayed or refused.
For additional information or assistance in processing a return, please contact the Brand Partner from whom the product was originally purchased, or the Nerium International Support Department
at neriumsupport.com or 855-463-7486. (855-4-NERIUM).
Payment Method
Visa MasterCard Discover American Express
Card Number
Exp. (mm/yyyy) CVV
Billing Address
City ST Zip Code
Name on Card
Signature of Cardholder (required)
To enroll via email, please scan or take a photo of your application and send to enrollments@nerium.com.
All amounts shown are in U.S. dollars unless specified differently.
X
2795720
Felipe Huicochea Dallas TX