HARMONY JAPANESE GREEN TEA
Contoh
Formulir Pendaftaran Member
THE PAPYRUS GARDEN KAV No 19 Setiabudhi – Bandung
Telepon / Fax: 022 – 2003236, email: bestindoharmony@gmail.com
http://www.entplus.co.id, http://www.ent-plus.com
FORMULIR PENDAFTARAN MEMBER
Sponsor ID : ID48616934 / ID48616934-1
Upline ID : ID48616934 / ID48616934-1 ( Left/Right ) (coret yg tidak perlu)
wawan kusmawanNama Upline : Iwan 1 / Iwan suwandi 1
wonkNama Lengkap :
21 januari 1980Nama Panggilan :
3210192101820021Tanggal Lahir :
+62857-9593-4207No KTP/SIM /PASPOR :
NarsihNo Telepon /Handphone :
Laki-lakiNama Ibu kandung :
iwan.scoterist@gmail.comEmail :
Jenis Kelamin :
ALKAUTSARAhli Waris :
Kios Pak Tarim Rt.03/ Rw.02, Desa Trajaya, PALASAH - MAJALENGKA 45475Alamat :
0046-01-014948-50-1Nama Bank : BRITAMA
MAJALENGKANo Rekening :
MAJALENGKACabang :
Kota :
A/n Pemilik Rekening : Wawan kusmawan
| No | Pilihan Produk | Harga | Jumlah |
| 1. | Expresso Harmony Chocolate | Rp 300.000 | 1 |
| 2. | Propolis Brazilian | Rp 300.000 |
|
| 3 | Harmony Water Stick Alkaline | Rp 300.000 |
|
| 4. | Magic Power Ring For Man | Rp 300.000 |
|
| 5. | Harmony Neodymium Bracelet | Rp 900.000 | 1 |
| 6. | EMR Shield | Rp.300.000 |
|
| 7. | Bio Patch | Rp.300.000 |
|
| 8. | Harmony Japanese Green Tea | Rp.300.000 |
|
| 9. | Bio Harmony Sanitary pad | Rp.300.000 |
|
| 10. | Rp.300.000 |
| |
| 11. | Virgin Plus in Harmony | Rp.300.000 | 1 |
|
| Total |
| Rp.1.500.000,- |
Majalengka 11 november 2011
( ……………………………)
- BANK TUJUAN TRANSFER PEMBELIAN PRODUK ENT-PLUS
- Cabang Setia Budhi Bandung
A/N Bestindo Harmony
No. Rek : 2331-900-313
Bank Mandiri
Cabang Setia Budhi Bandung
A/N Bestindo Harmony
No. Rek : 1-3200-104-39-405
Bank BRI
Cabang Setia Budhi Bandung
A/N Bestindo Harmony
No. Rek : 0408 01 004 3355 04
Bank Mega
Cabang Setra Sari Bandung
A/N Bestindo Harmony Entplus
No. Rek : 01-073-00-11-0888-7
