Enagic New Zealand
Ukon DD Application Form

Please download a copy of this form for your records

Bank Information

Sponsor Details

Product

UKON A Capsules: JPY 76,000 | UKON C Soap: JPY 76,000

UKON A Capsules: JPY 68,000 | UKON C Soap: JPY 68,000

Shipping: UKON A Capsules: JPY 3,700 | UKON C Soap: JPY 7,300

Payment

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Credit Card Payment (Credit Card Holder)

Credit Card Details

Purchaser’s Name and Distributor ID if different from the Credit Card holder