Name * First Name Last Name Phone (###) ### #### Email * How much water do you drink a day? * 2-4 Cups 4-8 Cups 8+ Cups How many times do you eat fast food a week? * (That's 21 total meals a week) 1-2x a Week 3-5x a Week 7+x a Week How many meals do you prep at home? * 1-5 Meals 5-10 Meals 10-15 Meals 15+ Meals You have been entered in the Giveaway for $50.00 to INFUSION COFFEE & TEA! THANK YOU AND GOOD LUCK!
