Tell Me About You

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Tell Me About You

This form is simply used to gather information before our call. It is not a binding contract rather an informal way to get to know your needs before we chat.

First & Last Name *

Instagram or Social Handle *

Are You Ready to Partner With The Modere Brand and Qualify For Commissions? *

YES!!

No thanks (I do want to try the products though)

What's Your Experience With Modere (select all that apply) *

I've Visited The Websie

I've Never Tried The Products

I've Researched The Products But Would Like More Detailed Information

I've Been Using The Products Already & I'm Ready To Promote

I've Seen Others Promote & I Would Like To Do The Same

Required

Which Products Are You Most Interested In Promoting? (select all that apply) *

Liquid Biocell (Collagen)

Trim (Collagen + Fat Loss)

Cellproof (Skincare)

Other:

Required

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