Please Complete and Click the "Submit My Response Now" Button:
Coffee
Diet Drink
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Indicate which, if any, of the following drinks you consume daily by clicking the box in front of the appropriate beverage or beverages.
Tea
Energy Drink
Soft Drink
Bottled Water
If you could substitute or replace your beverage or beverages of choice with a healthy drink that tastes great at equivalent cost or less and with very healthy benefits would you do so?
Yes
No
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If you could continue to consume the same amount of beverage for no more than you currently spend, yet have more energy and focus and lose weight in the process, would you want to learn more?
Yes
No
Are you aware of the health benefits of Green Tea, EGCG, Acai, Noni, Resveratrol, Pomegranate Juice, and Trace Minerals?
Yes
No
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Yes
No
Do you work out or participate in strenuous physical activities?
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Would you be interested in caring for your skin or skin conditions by merely drinking a great tasting, specially formulated drink daily for less than the cost of a cup of coffee?
Yes
No
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If you try our product and like it as much as we know you will, would you be willing to share your discovery with others?
Yes
No
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Would you be interested in learning how you can very simply create a secondary income stream by sharing this simple and unique product with others?
Yes
No
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Yes
No
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Do you have a Plan "B" for your financial future in this uncertain economic climate?
Do you know at least 3 to 6 people who use one or more of the various categories of beverages listed above?
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Yes
No
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Your name:
* Required Field
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Email:
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Phone:
Best Time Of Day To Contact
Morning
Afternoon
Evening
Your Level Of Interest On A Scale Of 1 to 10
10
9
8
7
6
5
4
3
2
1
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