CELAVIVE Holiday Pack Order Form

Marked "*" is all required items.

Celavive Holiday Pack
Cleanser, Toner, Day Cream, Night Cream, Serum, Eye Nourisher, Makeup Remover total 7 products)+ 2 Box of Celavive Cotton, 2 Sample Serum Set(3-day use) and 7-day Healthpak pouches/Price; 29,700 JPY (Tax inclusive) 111points

● Orders are to be shipped on the receipt of payment (FREE shipping)
● Limited time only until December 28, 2018
● Limited quantity
● Bank Transfer (ATM) has to be made by Friday December 28. Otherwise orders will be cancelled.

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[プライバシーポリシーの表記]for Privacy Policy
[特定商取引法に基づく表記] for Necessary Information about Enrollment and Product Purchase
[返品特約についての表記] for Product Return

Your Name *
Your ID number *
*Please call Customer Service if your ID number is unknown.
Business Center# *
Only for Associates. Please specify your BC number to add points.
Left/Right *
For Associates ONLY. Please choose the side to add points.
Email *

*Please enter your email address 2 times.
2nd line is for the confirmation.

The order confirmation will be sent to your email address.

Number of Pack *
Please choose the number of pack

Choose Shipping Address *
Please choose shipping address.
Shipping Address Postal Code
Please fill in postal code by 3 digits(first box) and 4 digits (second box), then click [住所検索] button.
Then your city and town address is added automatically so that just fill in street address or room# or other details.
Shipping Address
Shipping Phone Number

Payment Methods *
Please choose Payment Method.
◆If you choose "Credit Card for My Auto Order", No need to enter other information.
◆If you choose different Card Card, please fill in the credit card information below.
◆If you choose Bank Transfer, please calculate the total amount and transfer it to one of USANA's bank account.
Credit Card Number
Expiration Date
Card Holder Name
The Applicant name and Card Holder name have to be the same.
Any Requests and Inquiries
Please enter any inquiries.
USANA will contact you before your order is processed.
Customer Service
Mon-Fri 11am〜7pm

USANA Health Sciences Japan LLC.
〒102-0073 東京都千代田区九段北4-1-9-2F

▼To go to Confirmation page, click [内容確認] button below
▼To clear and start over, click [書き直し]button below

★★★★On Enrollment Confirmation Page★★★★
◆To complete your enrollment, click [送信] button
◆To return to previous page, click [戻る] button