EM Distributor Signup

Distributor Request Form

Your name:

Phone number where you would like us to contact you:

Your email address:

General area where you would like to be a distributor:

Who were you referred by:

Your emergency and

medical information

on a thumb-drive

What you get and how it's easy to earn money:

1. Personal webpage (click to see sample: www.themedicalpassport.com/mike.html)

We build and maintain your webpage

Send people to your page and share your link

Purchases from your page are $10 off retail price

You earn $7.50 for each Medical Passport purchased with your code

2. Your promotion code (click to see where it works: promotion code)

We use your name (easy to share and remember) as a promotional code

Customers can go to our website to learn about the Medical Passports

With your code, they get 20% off purchases

You earn $7.50 for each Medical Passport purchased with your code

3. Personalized marketing materials (click to see sample: business card)

We provide personalized PDF files to you:

Business card

ii.

Marketing brochures

We also have Power Point, logo and jpeg files for you to produce your own materials

4. Bulk purchase prices

We provide Medical Passports in bulk to you at huge discounts

You organize sells (as few as 100 Medical Passports qualify)

You set the price to earn as much $25 per Medical Passport sold

How to become a distributor:

1. Complete “Distributorship Request Form” below*

2. Talk with us by phone (we will contact you when you submit the form below)

3. After phone call approval we will email you a link to the “Distributor Signup and Agreement”

4. Complete the “Distributor Signup and Agreement” and pay $25 for yearly subscription.

5. We will then set you up as described above and send you all the necessary files and links

* To maximize earnings for our distributors - we reserve the right to deny distributorships for already served areas.

Huge Earnings

Only $25/year Distributorship