The EX Program Wallet Card Idea Submission Form
We're looking for members of EX Community to contribute ideas for wallet cards specifically for sale for EX Program clients. These ideas will help improve the design of our cards. We're open to all ideas that will prompt members to register for BecomeAnEX.org.

By submitting content on this form, you consent for the EX Team to use content you're submitting either in whole or in part to promote the EX Program. Content may be edited down from its original version by the EX Team to fit the format of the card.

The team behind BecomeAnEX launched the the EX Program (TheEXProgram.com) so that we could further our mission in helping more people quit tobacco. The EX Program works with employers and health plan providers to offer additional services to their members and helps keep BecomeAnEX.org free for all current and former tobacco users on their tobacco-free journeys. Your content may be featured on wallet cards for purposes of promoting the EX Program.

Submissions should be received by 11:59pm Eastern on 09/21/2018.

Email address *
Ensure you use the same email address you use on BecomeAnEX.org
Your answer
What text on a wallet card would encourage you to register for BecomeAnEX? *
Your answer
What imagery WOULD encourage a potential quitter to pick up the wallet card?
Your answer
What imagery WOULD NOT encourage a potential quitter to pick up the wallet card?
Your answer
May we use your content? *
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