Juice Plus+ ® Ordering Information Date: _______

(all products ship in a four month supply and include shipping)

Quantity
®
Juice Plus+ Trio: Every color of the rainbow!
Orchard, Garden and Vineyard Blends
$68.50/month ($2.28 per day)

Juice Plus+® Orchard and Garden Blends

$41.75/month ($1.39 per day)
**(If participating in the Children’s Health Study please
complete highlighted area below.)

Juice Plus+® Vineyard Blend

$26.75/month ($.89 per day)

Juice Plus+® Chewables

$22.75/month ($.75 per day child) _____
$44.50/month ($1.50 per day adult) _____

Juice Plus+® Complete

Meal Replacement Shake Chocolate _____
$27.75/month Vanilla _____
4 cans of 15 servings Variety (2 of each) _____
each($1.85 per shake)
Yes! Enroll me in the Fitness Effect program. I will exercise 30 minutes each day for 5 days per week.
I will participate in a short survey in 90 days to receive, with my next shipment, a complimentary choice of:
2 bottles of Vineyard _____ OR a variety package of 2 cans of Complete _____
**Children’s Health Study:
Sponsoring Adult’s Name___________________________ Child’s Name__________________________
Child’s Birthdate_________________ College Attending (full time under grad)______________________
Student’s Email_________________________________
Adult and participants 13 and older receive capsules.
Desired Juice Plus+ for 4-12 (please indicate): Capsules_______ Soft Chewables_______
Name________________________________________________E-Mail____________________________________________

Address______________________________________________City______________________________________________

State _____________________________ Zip ______________Home Phone (________) __________ - _________________

Method of Payment: ___Visa ___ MC ___ Am Ex ___ Discover

Card Number: __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __

Expiration Date ______/______/_______Name on Card ________________________________________________________

Jerry & Nancy Kroupa
Bank Draft: Bank Routing # __ __ __ __ __ __ __ __ __ 231 946-7877 ~ www.kroupa.com
Checking Account # __ __ __ __ __ __ __ __ __ __ __ __ __ __ __