Co-Applicant Account Add-On

Please note that this Form is intended for those OPTAVIA Coaches who wish to add a spouse (which includes those individuals bound by a marriage, civil union, domestic partnership or common-law marriage) to their OPTAVIA Coach account. Should one or more individuals, who are not spouses, wish to operate a single OPTAVIA Coach business, then those individuals must create a Business Entity. Only spouses may be added as a Co-Applicant to an OPTAVIA Coach account. However, spouses who are running an OPTAVIA Coach business are not required to add a Co-Applicant in order to add their spouse to their account; Coaches can add both spouses’ names to the “primary” account holder position, i.e., designating the Coach business as “Susan and Tom Smith” in the primary account holder position. When adding both spouses in the primary account holder position, all communications from the Coach business will come from “Susan and Tom Smith.” However, if the Coaches wish for communications to come from one spouse only (i.e., the primary account holder), Coaches will need to submit this Form to add a Co-Applicant to the account.

Primary OPTAVIA Coach ID*

Country of Residence*

Select

Primary OPTAVIA Coach First/Given Name*

Primary OPTAVIA Coach Last/Family Name*

Primary OPTAVIA Coach Email Address

By checking this box you are agreeing that the above-referenced individual should be the Primary OPTAVIA Coach on the account and that the Primary OPTAVIA Coach agrees to all Terms and Conditions of the Independent OPTAVIA Coach Agreement and all Policies and terms associated with same, which may be found here: For U.S. Coaches - https://optaviamedia.com/pdf/terms-conditions/OPTAVIA-Terms-and-Conditions.pdf

Agree*

Co-Applicant Add On

Co-Applicant's OPTAVIA ID

Co-Applicant's First/Given Name*

Co-Applicant's Last/Family Name*

Co-Applicant's Email Address*

Relationship*

By checking this box, the above-referenced individual has requested to be added as a Co-Applicant to the OPTAVIA Coach account and this individual is affirming that he/she is a spouse of the Primary OPTAVIA Coach. In addition, by checking this box, the Co-Applicant is agreeing to all Terms and Conditions of the Independent OPTAVIA Coach Agreement and all Policies and terms associated with same, which may be found here: For U.S. Coaches - https://optaviamedia.com/pdf/terms-conditions/OPTAVIA-Terms-and-Conditions.pdf

Co-Applicant Agree*

Please select if you want this change to be made on your OPTAVIA Path to Achievement recognition.*

Yes

Recognition Name*

Please include Primary Coach & Co-Applicant names

Send me a copy of my responses

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