Corporate Subscription Form
Step 1 - Please complete the following information.
Your Name:
Your Title:
Your Company Name:
Your Email Address:
Your Telephone Number:
Company Mailing Address 1:
Company Mailing Address 2:
Company City, State, Zip:
Billing Address:
Billing City, State, Zip:
Billing Phone:
Step 2 - Would you like weekly or monthly?
Number of employees at your company:
Receive:
weekly
monthly
Step 3 -Please list you primary and secondary contact. Each will receive the tips.
Primary Contact Name
:
Phone:
Primary Contact Email Address:
Secondary Contact Name
:
Phone:
Secondary Contact Email Address:
Questions?
More comfortable ordering through a customer service representative or via fax? No problem.
Please call
800-884-6446
or fax the above information to
818-884-2086
.
Submitting this form confirms your acceptance of the Health-E-tips Terms at
www.healthetips.com/terms.htm.
COMPANY Policy
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