Joining Form | The Royal Blizz

Free Brand Registration Form

Enroll with Modicare through The Royal Blizz and step into the world of affordable luxury. Become a Marketing Affiliate or Brand Ambassador for Modicare’s world-class products, earn your own royalties, and unlock your full potential as you build a path to true luxury.

Personal Details

Address

Contact Details

First Name

Last Name

Birthday

Co-Applicant Name

Co-Applicant Birthday

Flat, House No., Building, Apartment

Area, Street, Sector, Village

Address, City, State

Landmark

Pin Code

Email

PAN No.

Why we need it:
We request your PAN (Permanent Account Number) to comply with government regulations for income tracking and tax purposes. It ensures your earnings through Modicare are reported correctly and helps you receive payouts without any legal or tax issues. Your PAN details are kept secure and confidential.

Mobile No.

Alternate Mobile No.

Document Front Image

Upload File

Upload supported file (Max 15MB)

Why we need it:
KYC (Know Your Customer) information is needed to verify your identity, protect your account, and meet government compliance standards. It helps ensure that all Modicare transactions are safe, transparent, and secure. Your KYC details remain strictly confidential and are used only for verification purposes.

Document Back Image

Upload File

Upload supported file (Max 15MB)

Select NEFT Document

Upload File

Upload supported file (Max 15MB)

(Please provide a cancelled cheque or the first page of your bank passbook)

Why we need it:

We need your NEFT (National Electronic Funds Transfer) details to ensure your Modicare income is transferred directly and safely to your bank account. Providing a cancelled cheque or passbook copy helps us verify your bank information correctly and avoid any payment issues. Your banking details are kept private and secure.

I agree to give The Royal Blizz the rights to use all of the above information and documents for Modicare Registration.

Thanks for submitting!

Free Brand Sign Up Form

Experience the Bliss — No Strings Attached

At The Royal Bliss, we believe in freedom of choice.
You are never forced to share, sell, or recommend our products to others.
If you simply want to experience the joy of affordable luxury for yourself — no commitments, no marketing, no brand ambassador duties — you absolutely can!

You don’t need to register as a Brand Ambassador.
Just sign up for free and enjoy shopping for yourself.

Plus, signing up gives you more benefits — special offers, member-only discounts, and early access to new launches — compared to shopping without an account.

Fill out the form below and begin your personal journey with The Royal Bliss!

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