First Name Last Name Title Phone Email address Name of Health Club Address 1 Address 2 City State Zip Is this your (first) (second) (or more) request for samples? How did you hear about True Lemon? Advertisement: Diane Magazine Advertisement: Women’s Health & Fitness Article Family or friend Colleague Other: Please describe Type comments here
Approximately how many members do you have?
Where do you think you will put the True Lemon® samples? On the front desk Next to the water Other Other: Please describe Type comments here
Disclaimer: Grand Brands, LLC, reserves the right to verify the submitted information. If the information cannot be verified as submitted, samples will not be sent.
