AGS Fuel Atomizer Form

  Your fuel atomizer distributorship one stop order form . Just follow the instructions for you who are atomizer distributors .
  Be on your way to success today , its that simple .
P.O. Box 351
Riverton , Wyoming 82501
1-307-856-5484 - Office   -   24hr Fax: (208) 692-3632

AGS DISTRIBUTORSHIP PURCHASE FORMS ONLY

      As a distributor of the Auto Super Club (in connection with AGS Online) . I understand that I am fully authorized to purchase memberships on a quantity basis . Without filling out a regular Auto-Club Membership Application for each and every membership that I obtain . So long as I recognize that the rules and guidelines set forth in the regular Membership Application applies fully . And in every detail to each and every membership that I obtain even though they are in quantity form . And basically that is , that the membership is a purchase , and a Fuel Atomizer 2000 (product) is a Free Gift which accompanies each and every membership purchased .

      I further understand that the cost of each (5 minimum) memberships as a distributor (unless otherwise notified) shall be $95.00 inside the U.S. Borders , for all materials involved . Which must be paid at the time of the purchase , unless otherwise agreed to in writing . And includes a Fuel Atomizer 2000 with each membership purchased as my Free Gift .
      Having fully understood the foregoing statements , I the undersigned do hereby agree that when I set forth my signature on this Membership Purchase Form , that I fully agree with these terms , and shall abide by them on each and every membership purchased .

I , The Undersigned Do Hereby Express My Desire

To Purchase The Sum Of _______ Membership(s)

I am submitting $_____________ in the form of a:

__ Check or Money Order Enclosed.          Charge my:VISA__ M/C__ Visa__ Disc__.

                  
      
My Account Number:_____-_____-_____-_____
                
Expiration Date:___/___
         
Signature of Cardholder: ________________________________


Distributor's Partner or (Assoc.) Number:______________________


              
Distributor's Signature : ___________________
 
Your Email Address : ______________________
                                      
Date : ____/____



Dear Associated Distributor ,

      When ordering memberships , please fill out this Purchase Form , and mail it to us along with your check or money order made payable to AGS Online (or you may email it or fax it to us if using a credit card) . (If membership Fee is paid by personal check , do not expect delivery of materials until check has cleared your bank) .
IMPORTANT NOTE : Each membership purchase must be accompanied by a Membership Purchase Form , otherwise a 2nd membership purchase WILL NOT be honored . The warranty is void for each and every membership ordered in quantity without a signed form .
IF THE (Atomizer) FREE GIFT HAS BEEN TAMPERED WITH - SUCH AS DISMANTLED IN FULL OR IN PART , OR CHANGED IN ANY WAY , THE GUARANTEE IS IMMEDIATELY VOID , Please note this .
Ask for more information for distributions in your area here or , please print this form , fill it out , and (email) , mail or fax it to (001)-307-856-5484   or   (208) 692-3632 / 24 hrs . To place your purchase online just click here and order now . You can return to the distributorship information here , thank you .