Please submit the form below to Apply to become a partner in Longrich:

N/B: This Contract is Subject to a Cooling-Off Period of 5 Working Days

I certify that all the above information is true and correct. I have read and agree to the Terms and Conditions contained on the reverse side of this document. I understand that this Independent Distributor Agreement is only effective when the registration is confirmed in the Longrich back office. LONGRICH has the right to withhold my commission or cancel my membership if i fail to comply with the conditions stated in the Distributor Agreement.