Application Form
VivaAyush Enterprises India Pvt. Ltd.
Address : Office No. 409-412, Vision 9, Sr. No. 125/4, Opp. Om Dattaraj Mandir, Pimple Saudagar, Pune-411027
Url : http://www.vivaayush.com
Email : customercare@vivaayush.com Phone : 9021600999

Personal Information
  Date of Application *
  Applicant's Name * Enterprise Name
  Partner's Name Date of Birth *
  Nominee Name Nominee Relationship

Contact Information
  Address * City *
  PIN Code * State *
  Email * Phone
  Mobile Number * Pan Number *
  Adhar Card No. GST No.

Banking Information
  Bank A/C No. * Name of Bank *
  Name of Branch - City * Name on Cheque/DD *
  IFS Code *    

Office Information
  Distributor ID * Organisation
  Sponsor's ID *
  Password * Confirm Password *
  Transaction Password * Confirm TXN Password *

  Wallet Details      
  Wallet Holder Member ID *    

  Product Details      
 
Sr. No. Product Name DP BV Qty Select
1 Free Joining 0.00 0.00
2 Soft Cream Bathing Bar (75 gm) 60.00 18.00
3 Shaving Cream (50 gm) 70.00 21.00
4 Tooth Paste (100 gm) 81.00 24.00
5 Aloe Vera Gel (Multi Purpose - 100 ml) 99.00 30.00
6 Sanitory Napkins 150.00 45.00
7 Herbal Face Wash - Neem Tulsi (100 ml) 150.00 45.00
8 Herbal Bathing Bar - Papaya (75gm x 2 pcs) 150.00 45.00
9 Oxygen Scrub GEL (100 gm) 199.00 60.00
10 Herbal Oxygen Face Mask (100 gm) 199.00 60.00
11 Herbal Moisturising Cream (100 gm) 199.00 60.00
12 Herbal Face Wash - Oxygen (100 ml) 199.00 60.00
13 Herbal Body Lotion (200 ml) 199.00 60.00
14 Fairness Cream (100 ml) 199.00 60.00
15 Herbal Hair Serum (100 ml) 399.00 120.00
16 Stevia Drops (30 ml) 499.00 150.00
17 Spirulina Extract Capsule (60 capsules) 499.00 300.00
18 Nano Curucumin Liquid (15 ml) 499.00 300.00
19 Flax Seed Oil (60 Capsules) 699.00 420.00
20 FOOT PATCH 1350.00 1000.00
21 COW COLOSTRUM 1499.00 1000.00
22 Wellberry (60 bags) 1899.00 1140.00
23 Protein (500 gm) 1899.00 1140.00
24 TOUHG PLUS (1000 ML) 2999.00 2500.00
25 Educational Pens 3000.00 1800.00
26 Noni Enzyme (6 Bottles of 10 ml) 3499.00 2624.00
27 GAS SAFETY DEVICE 3999.00 2500.00
28 VIVA PREMIUM SUIT LENGTH 3999.00 4000.00
29 NEW PREMIUM SUIT LENGTH 4999.00 5000.00
30 VIVA PENDENT 4999.00 5000.00
31 KIDS EDUCATION BOOK 5499.00 3200.00
32 Viva Flower Boost 5599.00 5000.00
33 Viva Ayush Fert 5599.00 5000.00
34 VIVA ELEGANT TUNGSTEN BRASLET 5599.00 5000.00
35 VIVAA SILK SAREE 5699.00 5000.00
36 Green Bubble - RO (12 ltr) 16999.00 10000.00
37 Green Bubble - Alkline (12 ltr) 18999.00 10000.00


Note
  • Please Provide The Correct and Authenticated PAN Number of Person Who Will Get registered, It may get verified by company.
  • Please Enter Correct and full correspondence address with Pin code, Aadhar No. and Contact No.
  • Please verify all details before submitting to company