ACCOUNT INFORMATION:

Your Name: ____________________________________________________________________

(Last) (First) (M.I)

Company Name (if applicable): __________________________________________________

Social Security Number (or Business Tax I.D. Number): ______________________________

Address:_____________________________________________________________________

City:_________________________________ State: _________________Zip:______________

Tel # (Bus or Cell): _________________________(Res #): _____________________________

(Fax #): ___________________________Email Address: _____________________________

Sponsor’s Name: Berry Ball    Sponsor’s ID #: 21369

Sponsor’s Email Address: berry@detailshere.com

I am activating _______ Commission Centers in the 2x2 Matrix. Each CC is $300.

______________________________________________________________________

Note: The benefit to having Multiple Commission Centers is very simple: each CC can earn $1,200 in
commissions (or more) per month based on the income projections as presented in this business overview.
The activation of multiple CC’s is a great leveraging tool for those who want to maximize the income
potential of the 2 x 2 Marketing Plan. When activating more than 1 CC your #1 CC will be sponsored by the
person who introduced you to ReGenesis and the additional CC’s will be placed randomly in the company
matrix where needed as this will increase your likelihood of receiving upline spillover and it will also help
others to cycle through their 2x2 matrix. Every member whom you personally sponsor must be placed
beneath your #1 CC as this will help your direct sponsor to earn additional Royalty and 100% Matching
Bonus Income. Each CC that you activate will receive 2 new members through the Automated Recruiting
System™ and 300 opportunity seeker leads that you can use to promote any business opportunity.

______________________________________________________________________________________

Total Your Order Here: Commission Center Activation ________ ($300 per CC) + $25 one time
account set up fee (waived if activating 3 Commission Centers or more) = Total Order $_______

______________________________________________________________________

IMPORTANT PAYMENT INSTRUCTIONS: · If your order is greater then $1,000 you must
pay by bank cashiers check or money order · If your order is less then $1,000 we will
accept a check that is drawn in US funds from a US bank · For immediate matrix
placement fax your application, along with a copy of your check, bank cashiers check or
money order made payable to ReGenesis to: 1-866-330-4594 · Then send your application
and bank cashiers check, money order or check to:
ReGenesis
218 Main St, Suite 241,
Kirkland, WA 98033
by overnight carrier or through priority mail to insure that we receive your funds within 3-business days.

· 218 Main St, Suite 241 · Kirkland, WA 98033
· Tel: 800-691-3516 · Fax: 866-330-4594 · Email: regenesis2x2@gmail.com