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Application for Captains
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Contact Info

Contact Info

1.  Name

1. Name


2.  Address

2. Address


3.  city

3. city


4.  State

4. State


5.  Zip Code

5. Zip Code


6.  Phone Number

6. Phone Number


7.  Email

7. Email


8.  HCG Success Story

8. HCG Success Story

Write brief success story of your HCG weight loss experience including why you began the protocol, your experience and how you felt while taking HCG, how many pounds, inches, sizes you lost , what time frame you lost in. Also you may include anything that was special to you. Make it simple, motivational, inspirational to help others make that decision. How has this changed your life or your self esteem etc? Attach two digital before and after pictures with this email.

9.  Why do you want to help others with their weight loss protocol?

9. Why do you want to help others with their weight loss protocol?


10.

10.

Have you read Dr. Simeon's Manuscript?
11.

11.

Or Have you read The Weight Loss Cure by Kevin Tredeau?
You will receive an email back giving you Discount Codes to purchase Package A, Package B, or Package C.

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