MENU
Give Now
CLOSE
Who We Are
Our Mission
Child Nutrition Facts
Our Founder
Board & Staff
Contact
How We Help
Casa Herbalife
Disaster Relief
Success Stories
Humanitarian Award
Where We Work
Casa Locations
Help A Child In Need
Donate
Ways to Give
Join Us
Blog
HFF Insider
Donate
Casa Friends Nordic Royalty Deduction Form
*
1.
Question - Required -
Herbalife Nutrition Distributor ID:
*
2.
Question - Required -
First Name:
*
3.
Question - Required -
Last Name:
*
4.
Question - Required -
Country:
Please select response
American Samoa
Andorra
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Belarus
Belgium
Bolivia
Bosnia
Botswana
Brazil
Bulgaria
Cambodia
Canada
Chile
China
Colombia
Costa Rica
Côte d'Ivoire
Croatia
Cyprus
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Estonia
Finland
France
French Polynesia
Georgia
Germany
Ghana
Greece
Guatemala
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Kazakhstan
Korea
Kosovo
Kyrgyzstan
Latvia
Lebanon
Lesotho
Lithuania
Macau
Macedonia
Malaysia
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Namibia
Netherlands
New Zealand
Nicaragua
Norway
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Romania
Russia
Serbia
Singapore
Slovakia
Slovenia
South Africa
Spain
Swaziland
Sweden
Switzerland
Taiwan
Thailand
Trinidad & Tobago
Turkey
Ukraine
United Kingdom
United States
Uruguay
Venezuela
Vietnam
Zambia
5.
Question - Not Required -
Mobile Phone:
*
6.
Question - Required -
Email Address:
*
7.
Question - Required -
I would like to receive communication from Herbalife Nutrition Foundation.
Please select response
Yes
No
8.
Question - Not Required -
Date of Birth *Optional
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2040
2039
2038
2037
2036
2035
2034
2033
2032
2031
2030
2029
2028
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
*
9.
Question - Required -
I would like to:
Make a one-time donation to HNF
Make a monthly recurring donation to HNF
*
10.
Question - Required -
Gift Amount:
*
11.
Question - Required -
Donation Currency
Please select response
NOK
SEK
EUR
DKK
*
12.
Question - Required -
I would like to pay with a deduction from my Herbalife Nutrition:
Royalty Check
Production Bonus Check
*
13.
Question - Required -
Check type:
Local Check
Other Country Check (OC)
14.
Question - Not Required -
Monthly donation end date (MM/YY): For ongoing donations, please leave blank.
My donation must conform to all local laws and regulations. My donation may or may not be tax deductible. Because of local currency restrictions and laws, some countries are excluded from this method of donation. All amounts indicated herein are in U.S. dollars. Herbalife International is an international corporation, and as such maintains foreign exchange rates in house which it will use when donations to Herbalife Nutrition Foundation are calculated under Payment Option 2 above to remain consistent with Herbalife accounting systems. If royalty earnings for any given deduction are not sufficient to support the full deduction, no funds will be taken from that check. Donation deduction will carry forward until the pledge is paid in full. If it is not possible to deduct funds from your royalty check, HNF staff will be in contact to arrange for an alternative payment method. Herbalife Nutrition Foundation reserves the right to terminate this agreement at its discretion at any time. Contributor may cancel the automatic contribution by submitting a written cancellation directly to the Foundation. This request must be received by the Foundation two weeks prior to check processing. Once the donation has been processed, absolutely no refunding of the money contributed will occur.
By submitting this form, I understand and accept the above terms.
Spam Control Text:
Please leave this field empty
Original text
Contribute a better translation
f