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International Agent Application Form

Complete our international agent application form below online, or click here for a printable form in Microsoft Word format. The form may be completed and emailed to or faxed to +1-817-585-4006.



Company Information:

Company Name:
Contact Name:
Web Address: Date
Check all that apply Importer      Wholesaler                Distributor                 Retailer
Market Territory(List country, region/province, state or city)

Business Information:

How did you hear about “Novii Nutraceuticals & Bodycare products?  :
Will you be placing a trial order? (US Dollar Amount):
Projected order size amount per month:
Projected time you would like your agent-ship to start
Are you a new business or company?
How long has your company been in business?
Do you have or plan to own a website? If so, please provide name:

Marketing Information:

Please describe the marketing and advertising outline you have for the listed territory:

How many employees do you have?
# of outside sales people: # of inside sales people:

Sales Projection:

6 months: Company Annual Sales Revenue:
# of outside sales people: Profit % Margin Desired Per Unit:

Banking References:

Primary Bank:
Telephone #:
Bank Officer:
Account #:
Other Bank:
Telephone #:
Bank Officer:
Account #:

Trade References:

Contact Person: Title:
Telephone #: Fax:
Contact Person: Title:
Telephone #: Fax:
Contact Person: Title:
Telephone #: Fax:
All international agent agreements begin on a non-exclusive basis; however exclusivity will be assigned on a performance basis.
Payment Policy:
All orders are prepaid only. We accept bank transfers and online PayPal. Please note that no order is shipped until payment is secured.
Shipping Policy:
All shipment is FOB Borderless Exports, LLC, USA. All export/import fees are the sole responsibility of the international agent.
Please direct all questions to our customer care service @ +1-713-799-7444 or email

I/We authorize and request all of the above references to provide Novii Nutraceuticals & Boycare with any information requested and further certify that, all statements in this application are true to rely thereon by Novii Nutraceuticals & Bodycare to accept or reject this application. I/We further certify that I/we are authorized to execute this document on behalf of our business.

Your Name: Date:



vitamine series          special products          bodycare series


Novii Nutraceuticals and Bodycare Vitamin & Supplement Product Listing:


15 Day Cleanse Cape Aloe 450mg E-400 IU Infinite Male Nitro Stack Pack Stress B with C
A & D 10,000/400 IU Cape Aloe Lax EFA Complex Inositol Powder Nitro-Pump Super Calcium/Magnesium
Acai 600mg Carnitine 500mg Egg Protein Powder Joint Complex Pack Olive Leaf Extract Super Carb
Advanced Probiotic Cheat & Eat Enteric Coated Mega EPA/DHA Joint Support Advanced Pain-Q Advanced Super Energy Formula
African Mango 500mg Chol-Rx Support EPA / DHA Omega-3 Juice Complex Parasite Complex Super Fat Burner
ALA / ALC 750mg Choless Daily Pack Evening Primrose Oil Just For Life Complete Multi Pomegranate Super Vitamin Pack Packets
Amino Acid 1000mg Chromium - Picolinate Flaxseed 1000mg Krill Oil 500mg Potassium 99mg Therma Trim EF
Amino Acid 2200mg Cinnamon Complex Flex-Eze 900mg Lecithin 1200mg Power Band Energy Thyroid Support
Apple Cider Vinegar Complex CLA G Enhancer Life's Vitality PraviDerm Tribulus Terrestris 1000mg
B-100 Complex CoQ10 120mg Garlic & Parsley 500mg Lysine 500mg Probiotic Blend Turn Gray Away
B-12 1mg Sublingual CoEnzyme Q10 30mg Garlic 400mg Extract Maintenance Cleanse Prost-eze Turn Wrinkles Away
B-12 5000mcg Colon Complex Ginkgo Biloba 60mg Mega EPA/DHA Prostate Support Ubiquinol 50mg
B-12 500mcg Colostrum 500mg Glucosamine 500mg Mega Mineral Psyllium Husk Powder Ultra Mega-4 Minerals
B-6 50mg Combiferol Glutamine 1000mg Mega-2 Psyllium Seed 700mg V-4 Men
Bedtime Weight Loss Coral Calcium 1000mg Graviola 650mg Melaton Forte Raspberry Ketone Blend Vegie-Vite
Beta Carotene Corti-Therm Great Hair Formula Melatonin 3mg Red Raspberry Complex Vision Support
Betasitosterol 500mg Cranberry Concentrate Green Coffee Bean Complex Men's Daily Pack Resveratrol 250mg Vitamin D3 1500IU
Blood Pressure Support Creatine Monohydrate Green Coffee Bean Extract Milk Thistle Complex 450mg Resveratrol 50mg Vitamin D3 5000IU
Blood Sugar Support Creatine Tri-phase Green Tea 95% Extract Mind Matrix Saw Palmetto 500mg Wakame Trim
Brazilian Burn with Acai CS / GS / MSM Complex Guarana 1000mg Monster Matrix Pack Selenium Water Away
Brazilian Cleanse with Acai DHEA 100mg Heart Support Monster Mix Serrapeptase Whey 26 Protein
C-1000 Complex DHEA 25mg Herbal Lax Monster Stack Pack Seven Day Cleanse Pack Whey Pro Protein
C-500 / rose hips DHEA 50mg hGH Support Mood Formula Soft Gel Multi Women's Daily Pack
Calcium 250 with D Digest Matrix 500mg Hoodia SRT 1000mg MSM 1000mg Source 10 Protein Womens Support
Calcium Pyruvate 750mg Digestive Enzyme 325mg Horny Goat Weed Muscle Maker III St. John's Wort 500mg X-tend For Men
Calcium/Magnesium Drug Free Detoxifier Immune Support New English Diet Starch Blocker 500mg Zinc 50m




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Phone: +1-713-799-7444

Fax: + 1-817-585-4006


7601 S Crowley Road Ste. #314
(PO Box 60457, TX 76115)
Fort Worth, TX 76134, USA


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