Auum Omega 3 - A Healing Balance

On-line Application Form


Independent Distributor / Membership Application


Pre-Authorized Payment Plan Agreement

Become an Auum MEMBER:
A $30.00 fee (including HST) will automatically be charged with your first order.
This Membership entitles you to purchase products for personal use at MMP (Monthly Membership Program) pricing.

Become an Auum DISTRIBUTOR:
A $30.00 fee (including HST) will automatically be charged with your first order.
You must provide your S.I.N. or Business Number.
Distributors will receive a complimentary bottle of Sublingual D (no substitutions) with the third consecutive MMP shipment after signup.

Payment will be taken upon receipt of this document via your indicated method of Payment.  There are no ON HOLD privileges with this Membership. If shipments are suspended, your Membership will be cancelled. You may submit another application and pay the specified fee to join again.

Credit Card Info.

Your Bank Info.      (Automatic Bank Withdrawal is for CANADA ONLY and requires void cheque)

Note: Automatic Bank Withdrawal is not available at this time. Please call Auum Customer Service to arrange payment if you do not have a credit card.
Email transfer may be an option.
By selecting the Agree check box below, I am applying to become an Auum Independent Distributor / Member and I am agreeing to participate in the Pre-Authorized Payment Plan Agreement (click here).
I have carefully read and agree to all terms and conditions of the "Independent Distributor / Member Application" and any policies and procedures of Auum.  I understand that I will receive no pre-notification of any debits and that debits to my account will occur five (5) business days prior to shipment date. I will receive an email receipt when payment is processed if I have provided my email address.  An Auum Independent Distributor or Member has the right to cancel their agreement with Auum at any time, regardless of reason. Cancellation must be submitted in writing to:
By selecting the Agree check box below, Auum warrants that it is collecting personal information from Members and Distributors solely for the purpose of conducting Auum business. This information will be used to send monthly and single time purchases to Members and Distributors, and to process payment for these products.  Your private information will NOT be sent to any outside agencies.  By selecting the AGREE check box you agree to allow Auum to retain your private information for these purposes.

Monthly Maintenance Program

The first shipment will be made on the date selected below UNLESS you CHECK "Ship Immediately".  If you check Ship Immediately your MMP will be sent upon receipt by Auum Customer Service and your second shipment will be on the date you selected below. 

Please note there will be the normal MMP charge for each shipment made.

Auum Products

Select any 1 or more (total maximum of 10) Items for your MMP Order

Save 15% off the retail price of your first product.
Save 30% off the retail price of any additional product in the same order.
(if multiple products are chosen, the lowest priced product ordered will receive the 15% discount for maximum cost reduction)
FLAT shipping fee of $9.95 applies to all orders.
HST will be added to all orders


Please specify the quantity of each product you’d like to receive:

Auum Essential D3A  -  100ml Liquid   ($45.00 Retail)

Auum Sublingual D  -  100ml Liquid   ($45.00 Retail)

Auum Omega 3D-Boost  -  120 Capsules x 500mg   ($35.00 Retail)

Auum Pets  -  250ml Liquid   ($35.00 Retail)

All prices are in Canadian Dollars
By selecting the "Agree" checkbox below, you request shipment of the products noted and acknowledge the payment will be executed as per your Pre-Authorized Payment Plan Agreement.