Business Opportunity XanGo Juice, a Mangosteen Drink Rich in Xanthones XanGo Juice | Join XanGo South Africa XanGo Malaysia

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Please fill out this form, so that you receive your XanGo ID already today. Your host will contact you with all dates, passwords and required information.

We recommend to pay by credit card (Mastercard or Visacard), so that you already receive your starterkit and the first boxes of XanGo in a few days.

If you like to pay via bank transfer, you will receive all necessary banking information and a reference number.

Even if you pay by credit card - indicate your own banking information, so that XanGo can transfer the commissions directly to you.

If you are visiting from outside Malaysia please contact us


Personal Information
Form of address  : 
First Name  : 
Last Name  : 
Date Of Birth  :  . .
Street  : 
   
Zip Code/City  :   
State  : 
Country  : 
Cellphone  : 
E-mail  : 
You will receive your access code in this email account.
Identity Card No.  : 
 
Sponsor Information
Sponsor XanGo ID  : 
Sponsor Name  : 
 
Your first order
First order  : 
    1 cases XanGo
 
Pay your order by credit card
Cardholder Name  : 
Type of Card  : 
Card Number  : 
Expiration Date  :   / 
Card Verification Number  :  (On the back of your card, find the last 3 digits)
   
Note : Your credit card information is not stored for security purposes