Monday, September 10, 2012

Herbalife: Contact Me!


Name:
Contact No:
Email Address:
Gender: Male
Female
Age: below 18
18-24
25-34
35-44
45 and above
Occupation:
Living Area: Pahang, Terengganu, Kelantan
Perak, Pulau Pinang, Kedah, Perlis
Kuala Lumpur, Putrajaya, Selangor
Negeri Sembilan, Melaka, Johor
Sabah, Sarawak
Are you Herbalife consumer? Yes
No
Have you registered as a Herbalife Distributor in the past 2 years? Yes
No
You are interested in: Lose Weight
Gain Weight
Shape Up
Improve Health
Improve Skin Complexion
Improve Energy Level
Business Opportunity
Additional info:

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