Healthy Women of 2017 - Your chance to share in $1,000 in prizes

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We want to hear your story, including your successes, challenges and insights. Any member can win a prize, regardless of weight loss. Healthy Women of 2017 is about celebrating and recognising your efforts.

Just by completing this form, you will go in the lucky draw to win $250 worth of Healthy Inspirations bars and shakes. You will also be considered for our 3 major awards for 2017.

1. $250 Healthy Inspirations bars and shakes - just by completing this entry.
2. $250 clothing store voucher. Slimming story of the year.
3. $250 clothing store voucher. Health story of the year.
4. $250 clothing store voucher. Inspirational story of the year.

Name *

First and Last Name

Phone

Number of kilos you have lost at Healthy Inspirations?

Number of cm you have lost at Healthy Inspirations?

Which is your Healthy Inspirations centre?

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This form was created inside of Dietflex.