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Registration Information
Please fill in the items necessary to accommodate your information needs.
This information will be kept confidential and not sold to others. It is for my use only to better serve the needs that you desire. When new products are availabe, items are on sale, or discontinued items are marked down for clearance the information you provide will be used to notify you of money saving opportunities. Your chance to be the first in your group to sport fun new items or purchase great gifts for friends and family while saving money. Thanks. Terry



Contact Information

Name
Company
Email
Product Name
Size, Color, etc.


Influences
What factors influenced you to buy this product?

  Company Reputation   Price
  Recommendations   Personal Service
  Quality   This Web site
  Other


Usage
How will you use this product?

  Business
  Personal
  Coaching or other (what?)


Age
What is your age group?

  under 18   40 - 49
  19 - 29   50 - 59
  30 - 39   60 and over
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