Membership Form

The Registration process is very easy.

All you need is to just complete the form and then identify the products you would want to buy as your first set. Pay the amount into the Longrich Bank Account and then submit the proof of payment so as to credit your account. We will then arrange for you to collect your products or we will courier to your door step.

Once you are a member we will place you on our mentorship program to ansure that you have access to all the guidance on your new journey to even greater wealth.

Applicant's Name *

First

Last

Gender *

Male
Female

Mobile Numbers *

Email *

ID / Passport Number *

Date of Birth

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Beneficiary Information

First

Last

Provide Full Names and ID number or Date of Birth of the person you choose to inherit your Longrich business should anything happen to you.

Banking Details *

First

Middle

Last

Provide Your Bank Name, Branch Code, Bank Account Number. This is for Longrich to pay-in your Bonuses.

Select Your Preferred Entry Level

These are the various Entry Level Options. Which ever option you select, you will receive Longrich Products to the value of the amount you pay. NB: THESE ARE BASED ON THE COUNTRY-PROMOTION FOR RSA, NAMIBIA, SWAZILAND and LESOTHO. IF YOU ARE OUTSIDE THESE COUNTRIES, PLEASE CONTACT US FOR YOUR RELEVANT ENTRY LEVEL COSTS.

Sponsor Details

Please provide Details of the person that referred you to this Opportunity. If you are not sure Just use the default information. Sifiso Sibeko

Message

Be part of The Movement…

Complete The Membership Registration Form

Our Predefined Richpack Entry Promo…