FREE Sample Request Questionnaire

** Due to the high response of request for FREE samples we have received within the last month, we must ask you a few questions in order to be able to mail out your free sample. This sample cost us $2.76 for each full-serving sample we mail to you. Please understand our position in this matter. We would love to send everyone a sample, but it is just not feasible at this moment. Thanks for your patience and understanding. If you have any questions, please feel free to call us toll-free at 1 (800) 919-3755. We will gladly assist you in anyway that we can **

--FREE SAMPLE--

PLEASE ANSWER THE FOLLOWING THREE (3) QUESTIONS TO BE ELIGIBLE FOR A FREE SAMPLE.

Will you promise to try the 7 Essentials Sample soon after you receive it?

	YES
	NO

Do you take any kind of daily Vitamin Supplement currently?

	YES
	NO

If you liked the taste of the Free Sample, would you buy 7 Essentials?

	YES
	NO

--SHIPPING INFORMATION--

PLEASE LET US KNOW WHERE WE MAY SHIP YOUR FREE SAMPLE.

--SHIP TO--

First Name*

Last Name*

Company

Address*

City*

State*

Postal Code*

Country*

Email*

Day Phone*

Evening Phone

--ADDITIONAL COMMENTS--

PLEASE LEAVE ANY ADDITIONAL COMMENTS OR QUESTIONS YOU MAY HAVE IN THIS BOX.

--CHOOSE YOUR FLAVOR--

PLEASE CHOOSE THE FLAVOR OF 7 ESSENTIALS SAMPLE YOU WOULD LIKE TO TRY.

--Act NOW for a ONE-TIME only BLOW-OUT Special, Never Before Offered!!

Purchase 7 Essentials TODAY, and you will receive ALL of the following for FREE!!!

1. FREE 16 oz. Mixer/Shaker to mix your 7 Essentials shake in. ($7.95 VALUE)

2. FREE sample of the flavor you did not purchase, either Chocolate or Power Fruits. ($2.76 VALUE)

3. FREE 15-minute consultation with our Trained Health Professionals to answer any questions you have about 7 Essentials or a particular health ailment. ($50 VALUE)

4. FREE Invitation to our MEMBER’S ONLY conference call with Dr. William Kellas, the developer of 7 Essentials and our other amazing health products. ($180.00 VALUE)

5. FREE Audio CD by Dr. Kellas – “The Whole Truth, in 30 minutes, about Whole-Food Supplements” ($9.99 VALUE)

6. FREE Full-Colored Newsletter delivered right to your Email Inbox! ($5.99 VALUE)

PLEASE NOTE: Monthly FREE Sample Quantities are Limited.

SPECIALS

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