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VEEX REGISTRATION FORM
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VEEX PROMO
Name *
AGE *
MM
/
DD
/
YYYY
CONTACT #
WHERE DO YOU WANT TO RECEIVE YOUR REDEMPTION VOUCHER *
EMAIL / VIBER NUMBER *
STORE ID NUMBER  (This is only valid for REGISTERED and AUTHORIZED VEEX RESELLER) *
What is your favorite V1 flavor?
PROMO REDEMPTION *
Required
PLEASE WRITE YOUR ORDER (COLOR OF THE DEVICE OR PODS) e.g 1 device pink + 1 box of veex orange soda
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