Karen Priemer's Sample Request Form
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1. Karen Priemer's Sample Request Form

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1. Please enter your contact information

Please enter your contact information Name:
Address 1:
City/Town:
State/Province:
ZIP/Postal Code:
Country:
Email Address:
Phone Number:

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2. Which of the following products do you use during your daily face washing regime?

Which of the following products do you use during your daily face washing regime? Wash Toner Serum Day Cream with SPF Day Cream without SPF	Eye Cream Night Cream Lift/Skin Tightener Neck Cream Shave gel (men)	Acne Wash/System Acne Medication/Spot Treatment Age/Sun Spot Lightener/Treatment Exfoliating Scsrub Other
Other (please specify)

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3. After sampling our product line, if you find our product formulations are higher quality, our product works as well or better than your current product and we can meet or beat the price you currently spend, would you be open to switching brands?

	Very Likely	Likely	Somewhat Likely	Not Very Likely	Not Likely At All
Switch your skincare regimen	*After sampling our product line, if you find our product formulations are higher quality, our product works as well or better than your current product and we can meet or beat the price you currently spend, would you be open to switching brands? Switch your skincare regimen Very Likely	Switch your skincare regimen Likely	Switch your skincare regimen Somewhat Likely	Switch your skincare regimen Not Very Likely	Switch your skincare regimen Not Likely At All
Recommend our products to others	Recommend our products to others Very Likely	Recommend our products to others Likely	Recommend our products to others Somewhat Likely	Recommend our products to others Not Very Likely	Recommend our products to others Not Likely At All
Try additional products made by our company	Try additional products made by our company Very Likely	Try additional products made by our company Likely	Try additional products made by our company Somewhat Likely	Try additional products made by our company Not Very Likely	Try additional products made by our company Not Likely At All

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4. If there was one thing you could change about your skin, what would it be?

If there was one thing you could change about your skin, what would it be?

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5. Please check all of the following that apply to your skin:

Please check all of the following that apply to your skin: Oily

Normal

combination

Dry

Acne Prone

Large Pores

Clogged Pores/BlackHeads

Scarring

Age/Sun Spots

Pregnancy Mask

Redness/Rosacea

Eczema

Uneven skin tone

Fine lines

Deep wrinkles

Dark under eye area

Crows Feet

Sagging/Discolored skin on Neck

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6. When making a purchasing decision, which is most important to you?

When making a purchasing decision, which is most important to you? Independent Clinical Studies proving results

Photo's showing before and after results

Testimonials from other clients

Personal experiences with the product

A recommendation from a friend

I tend to purchase based on product ads &/or commercials

Other (please specify)

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7. Which products would be of most interest to you and/or a member of your family?

Which products would be of most interest to you and/or a member of your family? Anti-Aging, Corrective Skincare for Women Anti-Aging, Corrective Skincare for Men Preventative-Aging skincare for Women Preventative-Aging skincare for Men Acne Treating skincare Anti-Aging Cosmetics Hair Care	Baby Care Sunscreen Age/Sun Spot treatments Natural Hormone Balancing Products Aromatherapy Detoxification products Spa products	Weight Loss Nutrition/Vitamins Energy Drinks Protein Shakes Fiber Leg Vein Therapy Muscle/Joint help
Other (please specify)

8. We are actively seeking people to help us promote our new products. If you like the samples you try, would any of the following promotional activities interest you? (Please check all that apply)

We are actively seeking people to help us promote our new products. If you like the samples you try, would any of the following promotional activities interest you? (Please check all that apply) Refer family &/ friends to Arbonne

Event Coordinator: Home Party

Event Coordinator: Virtual Party

Provide Online Referrals through Facebook

Provide Online Referrals through Twitter

Provide Online Referrals through an Existing Blog

Collect Catalog Orders

Team Leader: 20+ hours per week, recruiting, coaching & product sales

Sales Consultant: 10 - 15 hours per week, product sales

None

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Karen Priemer's Sample Request FormExit this survey

1. Karen Priemer's Sample Request Form

*1. Please enter your contact information

*2. Which of the following products do you use during your daily face washing regime?

*3. After sampling our product line, if you find our product formulations are higher quality, our product works as well or better than your current product and we can meet or beat the price you currently spend, would you be open to switching brands?

*4. If there was one thing you could change about your skin, what would it be?

*5. Please check all of the following that apply to your skin:

*6. When making a purchasing decision, which is most important to you?

*7. Which products would be of most interest to you and/or a member of your family?