Sugarless
07 3801 8215

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SUGARLESS CONFECTIONERY "SUGAR FREE CLUB" SIGNUP FORM

Please fill out the following survey to choose from our standard or premium membership.

STANDARD FREE LIFE TIME MEMBERSHIP


Receive notifications on new products and great recipe ideas as well as an invitation to visit our Victorian or Queensland warehouses for sampling for you and 5 friends once a year. Must be 16 years of age or older. You will also automatically be entered into all our monthly competitions.



PREMIUM PAID 12 MONTH MEMBERSHIP - Commencement date 1st January 2017 - $30 gst inc


Premium paid membership receives all the benefits of Standard free life time membership plus 10 packets of lollies free, valued at $30.00 delivered to your door. Please note these will be including our newly launched lines. If your premium membership is not renewed after 12 months you will be automatically provided with a standard lifetime membership. Your deliveries will be confirmed to you via email as they are on your way.


Full Name:




Phone Number:




Email Address:





Why do you buy sugar free products?


Are you diabetic?


Yes - Type 1
Yes - Type 2
Yes - Type 3
No

For Health & Lifestyle Reasons?


Yes - Low Carb
Yes - Gluten Free
Yes - Sugar Free
No

Are you adopting a sugar free lifestyle?


Yes
No


Are you conscious about your oral health?


Yes
No


Any other reasons why you buy sugar free products?




What is your age group?




What are your preferred sugar substitutes?


Maltitol
Stevia
Isomalt
I don't know what these are


Are there any sugar free substitutes you would like to see us use?




What products do you usually buy?


Aura
Chews
Chocolates
Jellies
Licorice
Lollipops
Marshmallows
Super Fruits


What is your favourite product?



Which Sugar Free Club Membership would you like to join?


STANDARD FREE LIFE TIME MEMBERSHIP
PREMIUM PAID 12 MONTH MEMBERSHIP (Payment options available after submitting survey.)

Terms and Conditions:

Non transferable.
No refunds.
Only one delivery address.
We deliver twice a year once in February and once in September.
New lines will include only our lollies as our chocolates have the potential to melt during postage.
Please note that we reserve the right to include our 10 packet special with your Birthday, Easter or Christmas gift which may lead to a small delay on the new lines delivery depending on your special occasion and our expected delivery date.