Picture This - Survey Page

The Pacesetter4u Team - Contact

Picture This... Product Survey

Now let's see if this business is for YOU. Please take the following Product Survey. We will process it and show YOU how easy it is to qualify for our program.

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Phone Number:	required Please include your area code
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e-mail:	*required*

Please select those products, below,
that you normally purchase for your home:

**Which Products do You Use?**
NUTRITION Vitamin/Cal. Sup. Antioxidants Child's Chewables Herbal Tea Fiber Bars/Cereals Fiber Drink Mix Energy Drink Mix Protein Diet Shake Fat Loss Products Energy/Power Bar Arthritis Remedy Sleep Aid	FACIAL CARE Acne Medication Antiseptic Cleanser Glycerine Bar Cleansing Cream Toner/Refreshener Morning Moisturizer Evening Moisturizer Makeup Concealer Facial Scrub Face Mask/Face Lift Alpha Hy./Anti-Aging Eye Cream	KITCHEN Dish Soap Automatic Dish Soap Liquid Hand Soap Appliance Cleaner All Purpose Cleaner Coppr/Brass Clean Silver Cleaner Floor Cleaner Disinfectant Cleaner Oven Cleaner Indust.Clean./Degr. Shower Cleaner Window Cleaner
HAIR CARE Condit. Shampoo Salon-Shampoo Salon-Conditioner Deep Conditioner Dandruff Shamp. Styling Gel Spray gel/Volum. Hair Spray	GARAGE Car Wash Boat Cleaner Bug & Tar Remover Indust.Hand Clean Windsh.Washer Con. Gar.floor/dr. Cleaner Oil & Grease Remover	SERVICES ISP (Internet Access) Long Distance Ser. Credit Cards Pharmacy Savings Travel Club
LAUNDRY Laundry Detergent Fine Washables Whitener/Brighten Stain Remover Fabric Softener Laundry Sanitizer	GENERAL HOUSEHOLD Window Cleaner Air Freshener Spot Carpet Cleaner Carpet Deodorizer Carpet Shampoo Furniture Polish	ORAL HYGIENE Toothpaste/Polish Child's Toothpaste Mouthwash Breath Spray Dental Floss
PERSONAL CARE Deodorant Antiperspirant Lux.Bath Bar Anti-Bacteria Soap Hand Lotion Body Lotion Frag. Body Cream Sun Screen/Block Lip Balm Shaving Gel After Shave Lot. Soothing Bath Oil Lux BubbleBath Bath/Shower Gel Men's Cologne Ladies' Perfume	PHARMACEUTICALS Burns/Cuts/Scrapes Sore Throat Spray Cold Sore Medication First Aid Oint. Pain Rub Chest Rub Antibiotic Ointment Hydrogen Peroxide Sunburn Foot Treatment Feminine Irritation/Itch Problem Scalp Cough Syrup Cold, Allergy, Sinus Antacid	BATHROOM Tub/Tile Cleaner Disinfect/Deodorizer Lime Remover Toilet Bowl Cleaner Air Freshener GIFTS Candles

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Your Success Coach: The Pacesetter4u Team - Contact

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