JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Codix Wellness Brand Ambassador Raffle Draw Qualification Form.
This form, once filled, qualifies you to partake in the Codix Wellness Brand Ambassador raffle draw.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
NAME
*
Your answer
Whatsapp Number & Location
*
Your answer
Tick which of our social media handles you followed or subscribed to
*
Facebook
Instagram
Linkedin
Twitter
Youtube
Required
TICK A PRODUCT OF INTEREST
*
SelCEA ( is a combination anti-oxidants Selenium , Vitamin A , Vitamin C and Vitamin E)
Codix Vitamin C+ D Effervescent Tablets.(Sufficient daily dose of Vitamin C with Vitamin D in a drink)
Winwell ( Multivitamin supplemenet with 25 active ingredients to support your win over stress and fatigue with Winwell)
Codix Fat Burner( CFB) Helps you burn fat without burning out. CFB Makes your weight loss goal achievable.)
Flexicod is a joint health formula that keeps your winning and ever on the move
Would you like to know more about Codix Wellness Club?
*
Yes
No
Other:
To validate your raffle draw entry we need to confirm your followership, kindly provide your social media name(s) below. For examplle Facebook-Jackjill, Instragam-Jack_gill.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report