kangen booking – BAGIL RMS

Full Name (as written in your valid ID Card) *

Email *

Phone Number/WhatsApp Number *

Separate multiple phone numbers with a space in between

Select your order item *

Kangen Machine
Kangen Water

Order Details

Water type needed: *

pH 11.5 (Strong Alkaline Water) >> ₦1500.00 per litre
pH 9.5 (Kangen Water) >> ₦300.00 per litre
pH 8.5/9.0 (Kangen Water) >> ₦300.00 per litre
pH 7.0 (Clean Water) >> ₦300.00 per litre
pH 6.0 (Beauty Water) >> ₦300.00 per litre
pH 2.5 (Strong Acidic Water) >> ₦1500.00 per litre

Quantity of Liters for the chosen option above: *

(example: 2, 4 etc)

Mode of Pickup *

Door Delivery
Our Pick-up points

Select your pick-up location *

Akobo flow station
Dugbe Head office

Detailed address for delivery: *

Select your Pick-up/Delivery Date *

Mode of Payment: *

Bank Transfer

Upload your payment receipt *

Drop your file here or click here to upload You can upload up to 1 files.

Kangen Machine Order Details

Select your type of machine being order *

K8
SD501 Platinum
SD501

Are you currently paying for another machine? *

Yes
No
I don't understand

Date of Birth *

Are you currently an Enagic distributor? *

Provide your distributor ID *

Valid ID Card Upload (International Passport, NIN Slip or Drivers License)

Drop your file here or click here to upload You can upload up to 1 files.

Detailed Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Years of Resdience in location above

Type of Residence *

Rent
Owned
Others

Annual Rent:

If you selected others, provide details here.

Current Employer Name *

Work Phone Number:

Years with Employer

Emergency Contact Name

Emergency Contact Phone Number

Relationship with Emergency Contact

Payment Mode *

One time payment
Installment Payment
Cooperative/Microfinance

Select your payment durations

3 months
6 months
10 months

Means of payment

Post dated cheque
Standing order from domicile bank
Direct debit via remita

Upload payment receipt of service charge (₦10,000) *

Drop your file here or click here to upload You can upload up to 1 files.

KANGEN PRODUCT(S) ORDER

Kangen Machine Order Details