To be eligible to receive your FREE Spiru-tein shaker cup, you must complete ALL questions that apply, and be at least 18 years old. Offer valid while supplies last. Limit one per household. U.S Residents ONLY. (click on Terms link for additional info)


NOTE. Nature's Plus respects the privacy of every individual who visits our websites or responds to our interactive advertisements. Our Privacy Statement outlines the information Nature's Plus will collect and how we will use that information. (click on Privacy link for additional info) (* Required Field, however, depending on your answers to questions #10 and #11, some questions become inactive.)



*First Name:
*Last Name:
*Address:
Address2:
*City:
*State:
*ZIP:
  Phone: () - (Area Code)(Phone Number)
*Email:


  If you were referred to this website from a magazine or flyer,
  please enter the 4 digit telephone extension found on the ad:  


*1. Your Gender:




*2.Your Age?




*3.Marital Status?




*4.How many children under 16 are living in your household?




*5. What was the last grade you completed in school?




   If other:


*6.What is your occupation?




   If other:


*7. What is the combined gross income of your household?




*8. Where do you shop for health food products?




*9.On average, how much do you spend on health food supplements per month?




*10. Are you currently using a protein supplement (including Nature's Plus Spiru-tein)?
If your answer below is NO, then please proceed to question #18.




*11. Which protein supplement brand are you currently taking?
To select multiple choices, hold the Control key down and select.
   If Nature’s Plus Spiru-tein is not your answer below, please proceed to question #15




   If Other:


*12.How long have you been taking Spiru-tein?




*13. Which Spiru-tein product(s) are you currently taking?
To select multiple choices, hold the Control key down and select.




*14. How were you first introduced to Spiru-tein?




   If Other:


*15. How often do you take a protein supplement?




   If Other:


*16. What is your most important reason for taking a protein supplement?




   If Other:


*17. What is most important to you when choosing a protein supplement?




   If Other:


*18. What would influence you most to buy Spiru-tein for the first time?

   If other:


*19.Would you purchase a Spiru-tein product that you have never purchased before, if you had a money saving coupon?

Yes No


*20.Would you purchase a Spiru-tein product that you have never purchased before, if you could try a free sample?

Yes No