Lifestyle of Choice - Contact Us

Please fill in the following form, and we will contact you as soon as possible (required fields are denoted by *).

"Resolve in advance to persist until you succeed, no matter what the difficulty." - Brian Tracy.

First Name	*
Last Name	*
Phone (whichever is best to contact you on)	*
Best time to call (day and time/range of times)
Email (if you do not have an email address, please type "none")	*
Street Address (include Suburb)
City
State
Post Code
Country	*
How did you find out about this web site?	*

What are you interested in? * Products Business Opportunity Both

Which of the following is most important to you?

About the products:

Why is that aspect of the products important to you?

If you would like to lose weight, how much would you like to lose? kg (1kg = 2.2 pounds)

About the business opportunity:

Why is that aspect of the business important to you?

What type of income are you looking for?

Up to $500 per month
$500 - $1,500 per month
$1,500 - $5,000 per month

Are you currently a distributor with Herbalife International?	Yes No
Do you realise that this is a business and not a job?	Yes No

What questions or comments do you have?
(Please write anything else you'd like to say or ask in the following text box.)

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Or you can contact us at:

Lindsay & Monika
PO Box 694
Thuringowa Central
Australia
Phone: 07 4773 5858 / International +61 7 4773 5858
Or: 0409 221 977
Email: info@lifestyleofchoice.com