Pure Herbal Products, LLC
Sun City, CA 92584
$10,000.00 Challenge
"OFFICIAL ENTRY FORM"
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Before Picture |
Name:____________________________________
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After Picture |
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Address:__________________________________ __________________________________________
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State:______________________________
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| Zip
Code:_________________________________
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| Contact
Number:(_______) __________________ |
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How much weight have you lost using Pure Hoodia products? |
________________lbs. | Which Pure Hoodia Products do you currently use? |
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Weight before using Pure Hoodia Products? |
________________lbs. | ( ) Pure Hoodia | |||||
| Current Weight? | ________________lbs. | ( ) Pure Hoodia Plus | |||||
| Height | _____Ft. ________In. | ( )
Both Pure Hoodia
& Pure Hoodia Plus |
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Signature________________________________________ |
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