Aplomb Health Care Limited

You are most welcome in the world of Aplomb. Here is an opportunity that makes a lot of change in your life and fulfills your desire. We assured you that Aplomb is a platform where you can get a good Health, Wealth and Prosperity for your life. So become an authorised Direct Seller and start your own business.

Eligibility to become a Direct Seller:

Persons aged 18 years and above can apply to be a Direct Seller of the company.
The company reserves the right to accept or reject an application.
The application must be sponsored by a pre-existing Direct Seller.
Spouse can have their separate registration in the same group.
Direct Seller ID is not transferable under any circumstances.

JOINING UNDER ID*

REFERRED BY ID

PERSONAL INFORMATION:

SALUTATION: *

APPLICANT NAME: *

DATE OF BIRTH: (DD-MM-YYYY) *

GENDER: *

MARITAL STATUS: *

OCCUPATION: *

S/O, D/O, W/O: *

NAME: (S/O, D/O, W/O, C/O) *

ADDRESS INFORMATION:

STATE: *

CITY: *

PINCODE: *

PERMANENT ADDRESS: *

CONTACT INFORMATION: (YOUR LOGIN ID & PASSWORD WILL BE SENT ON YOUR MOBILE)

MOBILE: *

E-MAIL:

AADHAAR AND PAN INFORMATION:

AADHAAR No.: *

PAN CARD NO.:

BANK ACCOUNT INFORMATION: (ALL THE FIELDS ARE MANDATORY OR YOU CAN SKIP THEM ALL)

BANK NAME:

ACCOUNT NO.:

IFSC:

NOMINEE INFORMATION:

SALUTATION: *

NAME: *

DATE OF BIRTH: (DD-MM-YYYY) *

GENDER: *

RELATION WITH APPLICANT: *

I hereby declare that all the details (i.e. Bank Account, PAN, Aadhaar, Address & Other Personal Details) given by me are true to my knowledge and I am fully responsible for the details given by me.

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Eligibility to become a Direct Seller: