Kangen Machine Pre Qualification Form & $1 Dollar Free TRIAL Survey

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1.Which Best Describes You?

Interested In $1 Dollar SHOPPING CLUB Membership (found at bottom of website)

Interested in KANGEN water Business, what are my best options to start?

I Want To Make Money From Home, I Would Like To See All The Prices & Options To Start

IN CENTRAL FLORIDA... I Want To Try KANGEN Water For FREE

I Just want a Sales Funnel For My Business / Traffic (leads) / Dialing Software / SCRIPTS / ETC...

I'm Ready To Start Or Buy A Machine TODAY , Call or Text Me... I May Have Some Questions

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2.Who invited you to this WEBSITE? VERY IMPORTANT: if you don't have a name of who invited you, list any information you may have (email, text, phone #. social media) as we want to make sure each person gets the proper credit for your attendance (just as we will do the same for those you invite)

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3.What is your Full Name

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4.What is your email address?

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5.What is your phone number? (Social Media Handle also Works - IG/FB/Twitter)

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6.How Do We Contact You Best?

Text Me First 📱

Call Me & Text Me 📞 📱

Social Media

In Person / Face To Face / ZOOM VIDEO ETC