Renavive™ - Wholesale Distribution Application

Please complete the form below - Required fields are marked with (*).

* First Name:

* Last Name:

* Business Name:

* Street Address:

Street Address 2:

* City:

* State/Province:

* Zip Code/Postal Code:

* Country:

* Contact Telephone:

Fax Number:

* E-Mail:

* Type of Business:
(check all that apply)

Health Food Store

Practitioner's Office

Fitness Store/Gym

Other:

What product(s) are you interested in ordering?

RENAVIVE™

More Products Available Soon!

* Years in Business:

* Monthly forecast of the amount of bottles you plan on purchasing?:

* Comments:

*Once the application is submitted, if approved, you will be contacted within 72 hours via telephone or e-mail with the wholesale retail distribution agreement and distribution terms.

*We are currently only accepting RETAIL Distributorships. We are not accepting online distributorships at this time, however we do offer
The RENAVIVE™ Affiliate Program.

The Benefit Of Drinking Distilled Water with Renavive™

Distilled water is the purest water available and does not contain inpurities or minerals. By taking Renavive™ and drinking a lot of distilled water will help ensure that the kidney stones will be flushed out of your body.

In most cases, kidney stones are caused by the sufferer’s lack of hydration (water intake), either by not drinking enough liquid or losing too much due to high heat conditions. If you are a kidney stone sufferer you should consume 8-10 glasses of DISTILLED water per day along with taking Renavive™! After months or years of consistent dehydration, the body cannot effectively flush toxins, impurities and calcium. And one result (of many) is calcium buildup in the kidneys. Fortunately, Renavive™ is available as a superior solution!

Please choose the best Renavive™ option for your kidneys stones:
*All options contain the same Advanced Renavive™ Formula. Consistantly take Renavive™ for at least 30 days. For optimum kidney stone cleanse results it is recommened Renavive™ be taken for 2-3+ months. Renavive™ may also be taken safely as a kidney stone preventative.

FDA Required Legal Disclaimer - These statements have not been evaluated by the FDA.
This product is not intended to diagnose, treat, cure, or prevent any disease.