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Be a Part of the AHAVA Journey - New Product Tester Application
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1.
What is your age?
(Required.)
Under 18
18-29
30-39
40-49
50-59
Over 60
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2.
What is your gender?
(Required.)
Male
Female
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3.
How would you describe the condition of your skin?
(Required.)
Sensitive
Dry
Oily
Combination
Showing age (wrinkles, lines)
Normal
Other (please specify)
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4.
Are you willing to send us written testimonials, photos, and/or videos before and after product usage?
(Required.)
Yes
No
Some, not all of those requirements
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5.
What do you consider your biggest face & body skincare problems that you would like to solve?
(Required.)
Get rid of wrinkles
Reduce puffiness
Reduce redness
Brighten dull, lack luster skin
Firm skin
Reduce size of pores
Moisturize dry, flaky skin
Soften and smooth skin's texture
Prevent or reduce acne/blemishes
Other (please specify)
6.
Do you currently include a mask as part of your beauty routine?
Yes, 2 or more times a week
Yes, once a week
Yes, but only when I need it
No
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7.
Where can we contact you? (this information is only used if you become an AHAVA Tester)
(Required.)
Name:
*
Address:
City/Town:
State:
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AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
Country:
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Email Address:
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