Isagenix

1. Name:
2. Associate ID:
   (if applicable)
3. State/Province:
4. Country:
5. E-mail:

1. When did you start using Isagenix products?
2. Who introduced you to Isagenix?
3. What were your goals when you began using Isagenix?
4. What was your first impression about the products?

1. What results have you experienced since you started using Isagenix? (Ex. Weight loss, inches lost, improved health and well-being, goals achieved, etc.)
2. What Isagenix products/systems have you used and/or are you currently using?
3. What are your tips for getting the best results with Isagenix products?

1. Please share your story about your experience with Isagenix.
2. What are your plans for the future and how does Isagenix fit in?
3. What resources did you find most helpful in using Isagenix?
   (Ex. Support from friends/family and other Associates, online resources, marketing materials, etc.)
4. Are you involved with the Isagenix business opportunity?

1. Are you willing to have your story shared online or in Isagenix materials (DVD, newsletter, etc.)?

   1. Yes
   2. No
2. Daytime Phone:
3. Evening/Cell Phone:
4. Best Contact Time:

Please upload up to three photographs of yourself and include the date it was taken and a description of each photo. If possible, please send full-body shots. We can accept files up to 2 MB in size. Suggested file types include: JPEG, PNG, TIFF or PICT.

1. Photo file upload:
2. Photo date (MM/YY):
3. Photo description:
4. Photo file upload:
5. Photo date (MM/YY):
6. Photo description:
7. Photo file upload:
8. Photo date (MM/YY):
9. Photo description:
10. Legal/talent disclaimer