Here’s what I need to open up your account and place your first customer order, when you are ready!

You receive 25%+ off retail price for a year as a PREFERRED CUSTOMER*!

Name      

Billing Street Address

     

Street

                 

City State ZIP

Shipping Address

(if different)

     

Street

                 

City State ZIP

Cell phone       Email Address      

Name (as on credit card)      

Credit Card #      

Exp. Date       CVV      

Which Pak are you ordering? 30 Day Basic Pak 30 Day Custom Basic Pak 30 Day Premium Pak ☐ ☐ ☐ 30 Day Value Pak 30 Day Family Ultimate Pak Other ____________☐ ☐ ☐

Pick Your Shake Flavors and Select Canisters or Packets

You can select (4) four of any combination of the flavors/options below (*some incur an additional cost).

Whey IsaLean Shake Choices (24 g protein) –

Dutch Chocolate; French Vanilla; Strawberry Cream; Chocolate Mint

➢ Canisters – Portion with included scoop.

➢ Packets – Individual portable portions and cost $.95 more per box (1 box = 14 packets)

Other Whey Shake Options –

IsaLean PRO (36g protein ideal for athletes, seniors, etc.).

➢ Natural Chocolate; Natural Vanilla; French Vanilla, Strawberry

➢ Additional cost and only comes in packets (+$9.95 per box)

For those with Dietary Restrictions –

IsaLean Non-Dairy Rich Chocolate or Vanilla Chai (packet form only; additional $5 per box of 14 pkts)

IsaLean Kosher Vanilla (canister only; additional $2 per canister of 14 servings)

➢ Your

Selections(pick up to

4)

❶       Canister☐ Packets☐

❷       Canister☐ Packets☐

❸       Canister☐ Packets☐

❹       Canister☐ Packets☐

Pick your Cleanse-Day Snacks Flavor

Choices – Chocolate; Vanilla; Non-Dairy Berry

➢ Your

Selection

     

Pick your Cleanse-Day IsaDelights Flavor (YES! Chocolate on Cleanse Days!!!)

Choices – Milk Chocolate; Dark Chocolate (DF); Dark Chocolate Mint; Sea Salt & Caramel Milk Chocolate

➢ Your

Selection

     

Additional Information to Help Me With Your Enrollment and Success!

Are you a regular coffee drinker?

Yes☐ No☐

➢ Read about the benefits of Isagenix Coffee

Are you interested in our Immune or Heart Shake

Yes☐ No☐

Boosters?

➢ Read about the benefits of the Immune & Heart (Cholesterol) Boosters

We highly recommend e+ naturally balanced energy shots and if you are working out/weight

training, we recommend AMPED Power or any of our AMPED line of Performance products

**If you would like to add additional product to your initial order, you will enjoy a 10% discount**

Specify your interest IsaCoffee☐ Sour Cream Whey Thins☐ __________________☐

e+ all natural energy shots☐ White Cheddar Whey Thin☐ Immune Booster☐

AMPED Power☐ BBQ Whey Thins☐ Heart Booster☐

For those ordering the 30 Day Premium or Value Pak, 10 meal replacement IsaLean Protein Bars, Whey Thins, e+ Energy Shots, are INCLUDED.

e+ Energy Shot

Raspberry Lemon Lime Apple Pomegranate☐ ☐ ☐

Whey Thin Choices

Sour Cream White Cheddar BBQ☐ ☐ ☐

IsaLean Protein Bar Choices (pick 1) – ☐ Chocolate Cream Crisp; Chocolate Peanut Crunch; ☐ ☐Chocolate Decadence; Lemon Passion Crunch; Natural Oatmeal Raisin; Nutty Caramel Cashew; ☐ ☐ ☐ ☐ Dairy Free Peanut Butter Chocolate, Dairy Free Chocolate Berry, Dairy Free Chocolate Coconut ☐ ☐Almond

***Extra Shaker Bottle, with coil, for blending shakes on the go ($8)

Yes☐ No☐

Make a Wish Donation: Join Isagenix in helping to grant the wishes of children with life-threatening medical conditions by making a $1 or more donation to Make-A-Wish®. Isagenix and its customers have contributed over $5 million dollars to Make-A-Wish in the past 3 years!

$1☐ $5☐ $10 _____________☐ ☐

*Preferred customer requires a yearly membership of $29 (with autoship rewards program) or $39 (without autoship rewards.)