Order Page

* Initial Order XanGo ® Juice:		$100 USD* /case + shipping
Your initial order is the the number of cases you would like to receive right away. Your order of XanGo ® Juice will be shipped as soon as your application is processed.

* Automatic Delivery Program (ADP) (Monthly Product Auto-shipment)		$100 USD* /case + shipping
What is ADP? XanGo has a convenient Auto Delivery Program. It makes sure that you never miss a day of drinking your XanGo ® Juice. Around the 14th of each month, XanGo, LLC will ship your order via UPS directly to your front door.

XanGo Membership:		*

In order to purchase your XanGo ® Juice at a wholesale price, you will be charged a one-time, non-refundable Membership/Distributor fee of $35 USD. With your Membership you will receive a FREE multimedia kit that includes a couple of DVDs and booklets about the XanGo product and company.

Your Information is Secured

Personal Information

Note: Information supplied will NEVER be shared outside of XanGo.

Your privacy is extremely important to us.

*First Name: *Last Name:

*Email :

*Phone:

*Social Security Number:

Needed for the IRS, for tax purposes.

We will NOT run a credit check or use your SSN for any other reason other than

to report your earning on a 1099 at years end.

*Password:

(6 characters Minimum)

Needed to log into your XanGo Customer Back Office

Shipping/Mailing Information

Product and Checks will be mailed to this address

Cannot ship to a P.O. BOX

*Address 1 :

Address 2 :

*City :

*State:

*Zip Code:

Credit or Debit Card Information

*Select Credit Card:

*Credit Card Number:

*Name as it appears on Credit Card:

*Expiration Date:

Your Credit Card will not be processed/charged at this time. We will call you and verify all the information submitted and give you an exact accurate total including shipping to your area and applicable taxes if any.

You have chosen Power Up 2 Health to be your XanGo sponsor.

* I agree to the policies and procedures of XanGo