Customer Information Form

Please fill out the below information to begin processing
your dōTERRA membership, should you have questions at any
point please don't hesitate to reach out to me personally:
781-294-0310 (call or text) or ihaveanoilforit@gmail.com

Welcome! I’m so excited to help you! Let’s get started!

First and Last Name*:    
*
Address*:                         
*
City*: 
*
State*:
*
Zip Code*:
*
Shipping Address:
(only if different than primary address)
Primary Phone #*:         
*
Primary Email*:             
*
Full Birth date*:             
*

Where Do You Want to Start? To view the details of these kits please visit:
http://media.doterra.com/us/en/flyers/enrollment-kits.pdf

Family Essentials Kit $150 ($36 savings)
Family Essentials Kit $150 ($36 savings)
Aromatouch Diffused Kit $150 ($32 Savings)
Aromatouch Diffused Kit $150 ($32 Savings)
Family Essentials Kit $150 ($36 savings)
 
Aromatouch Diffused Kit $150 ($32 Savings)
Emotional Aromatherapy Diffused Kit $195 ($69 Savings)
Emotional Aromatherapy Diffused Kit $195 ($69 Savings)
Cleanse and Restore Kit $245 ($81 Savings)
Cleanse and Restore Kit $245 ($81 Savings)
Emotional Aromatherapy Diffused Kit $195 ($69 Savings)
 
Cleanse and Restore Kit $245 ($81 Savings)
Home Essentials Kit $275 ($86 Savings)
Home Essentials Kit $275 ($86 Savings)
Natural Solutions Kit $550 ($230 Savings + $100 back in Product Credit)
 
Home Essentials Kit $275 ($86 Savings)
 
Natural Solutions Kit $550 ($230 Savings + $100 back in Product Credit)
 
Every Oil Kit $1825 ($630 in Savings + $200 back in Product Credit)
Every Oil Kit $1825 ($630 in Savings + $200 back in Product Credit)
 
Diamond Kit $2650 ($866 Savings + $400 back in Product Credit)
Diamond Kit $2650 ($866 Savings + $400 back in Product Credit)
 
Every Oil Kit $1825 ($630 in Savings + $200 back in Product Credit)
 
Diamond Kit $2650 ($866 Savings + $400 back in Product Credit)
 
Custom Kit $35 fee + the items you select at wholesale cost
Custom Kit $35 fee + the items you select at wholesale cost
 
Custom Kit $35 fee + the items you select at wholesale cost
 

 

If you chose the $35 custom kit OR if you want to add additional items to your kit please detail them here:
Payment Info: Card Number*:               *
Payment Info: Card Expiration Date*:     *
MM/YYYY
Payment Info: Card Security Code*:       *
Full Billing Address (if different than shipping address) 
 
Are you interested in sharing doTERRA with your friends & family for cash or free products? *
 
Yes! Let’s set up a time to talk more about this!
Possibly can you text or email me some more info first?
Not right now-just send me my oils please!*
 
Are you interested in hosting a class or DIY day where you and your friends can learn more about oils and make some DIY's? *
Yes! I know some people who would be interested! Let’s plan something!
Possibly- Can you text or email me some more info?
Not right now- thanks though!*
 
Just some "Compliance Jargon"...
By checking the box below you are consenting to becoming a dōTERRA customer, and understand your information will be sent for processing. To read all of the terms and conditions please visit this website: https://www.doterra.com/US/en/wholesale-customer-terms-and-conditions
Yes*