Codix Wellness Brand Ambassador Raffle Draw Qualification Form.

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This form, once filled, qualifies you to partake in the Codix Wellness Brand Ambassador raffle draw.

NAME *

Whatsapp Number & Location *

Tick which of our social media handles you followed or subscribed to *

Facebook

Instagram

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

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.

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