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Yes! I wish to receive relevant information and special offers (trial offers, coupons, contests, articles, etc.) from Iovate Health Sciences Inc. and its related brands/products, such as Hydroxycut. Section A: Provide your PERSONAL CONTACT INFORMATION First Name Last Name E-mail Address Re-type E-mail Address Address 1 Address 2 (optional) City State Select Alaska Alabama Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZIP Code Phone Number (optional) Sex (optional) Male     Female Age (optional) SELECT 18-24 25-30 31-35 36-40 41-50 50+ Occupation (optional) Section B: Complete your FITNESS PROFILE a.) Please rate the importance of each of the following fitness-related goals.   Not Important   Somewhat Important   Extremely Important   1 2 3 4 5 Lose Weight         Burn Fat         Increase Cardiovascular Fitness         Look Better/Improve Appearance         Increase Muscle Tone         Increase Muscle Strength           b.) Please indicate the frequency and weekly hours you spend doing each activity.   Times per Week Total Hours per Week   Weight Training/Lifting 0 1-2 3-4 5-6 7+ 0-1 1-3 3-5 5-10 10+   Cardiovascular Activity 0 1-2 3-4 5-6 7+ 0-1 1-3 3-5 5-10 10+   Section C: Complete your NUTRITION PROFILE a.) Please indicate what most appropriately describes your overall nutritional/eating habits. 1 Needs Significant Improvement "I don't put a lot of thought into what I eat, and have a tendency to make a lot of unhealthy food choices." 2   3 Balanced "I eat healthy, well-balanced meals, for the most part but I also allow myself to occasionally indulge." 4   5 Very Strict "I am very strict with planning and balancing all of my meals. Only high-quality healthy foods enter my body." Please check the box of the version(s) of the LeanLiving newsletter you would like to receive: (choose one) Men's Fitness Women's Fitness Your personal information will never be disclosed to any third-party mailing list without your express consent. By clicking on the "Subscribe for Free" button, you are confirming that you are a resident of the USA and that you agree to the terms of our Privacy Statement and Terms of Use. Update Your Profile | Unsubscribe