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Jeune Cie
Members - Change Membership Information

To change your membership information complete the information below and click the Send button. 

Use this form to change:
 - Name, address, etc.
 - Shipping Cycle - number of days between shipments 

(If you have problems using this form then contact us using the Contact Us form.)

1. CURRENT MEMBERSHIP INFORMATION:

Billing First Name (required):


Billing Last Name (required):


Billing Address (required):

Billing State (required):


Billing Postal Code / Zip Code (required):

Billing Country (required):


Account Number (if applicable):


E-Mail Address - e.g., myname@aol.com ( required) :


Phone Number (required):

Current Shipping Cycle (number of days between shipments):

2 NEW MEMBERSHIP INFORMATION:

Enter only information that is different than our current records.

New Billing First Name:


New Billing Last Name:


New Billing Address:

New Billing State:


New Billing Postal Code / Zip Code:

New Billing Country:

New E-Mail Address - e.g., myname@aol.com:


New Phone Number:



New Shipping Cycle.  Use this field to let us know how often you want to receive a new shipment.

New Shipping Cycle (number of days between shipments):



Shipping To Information (enter only if ship to information is different than the billing information).

New Shipping First Name:


New Shipping Last Name:


New Shipping Address:

New Shipping State:


New Shipping Postal Code / Zip Code:

New Shipping Country:
Additional Comments: