Membership Form

Name:
Email Address:
Contact Number
When is your birthday? (Our birthday boy/girl will receive exclusive promotions from us)
How did you hear about us	Facebook Email Printed Advertisement Friend Promotional Event
Please state his/her referral code (if you heard about us from a friend)
Would you like to receive updates via email of any ongoing promotions for our product?	Yes No
We will send you an email and notify your membership code. Thank you :)

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