*1.Are you a DUSA Member?
(Required.)

Yes

No

*2.Full name (first name and surname)(Required.)

*3.Email address(Required.)

*4.Postal address(Required.)

*5.Contact number(Required.)

*6.Deakin Student ID number(Required.)

*7.Are you following DUSA and Fodbods on socials?

DUSA
Instagram: @yourdusa
Facebook: www.facebook.com/yourdusa

FODBOD
Instagram @fodbods
Facebook: www.facebook.com/fodbods(Required.)

Yes

No

*8.Which flavour from the sample packs and nibbles would you most like to try?
(Required.)

Nibbles: Ginger & Spice

Nibbles: Dark Chocolate

Nibbles: Rosemary & Sea Salt

Sample Pack: Mint Chocolate

Sample Pack: Lemon & Coconut

Sample Pack: Raspberry Coconut

Sample Pack: Banana & Peanut Butter

Sample Pack: Peanut Butter Choc Chunk

Sample Pack: Double Chocolate