To be eligible for your free sample, you must fill out the form in its entirely. Please see "Limitations" below for more details.

* Required Fields

First Name:*
Last Name:*
Mailing Address:*
Apt/Suite:
City:*
State:*
Zip:*
Daytime Phone:*
Email:*
Age:*
Gender:*	Male Female

How did you hear about this sample?:*

	Internet
	Friend
	Ad in magazine
	Other

If you saw an ad, which magazine?:*

	Flex
	Musclemag
	Ironman
	Men’s Fitness
	Muscular Development
	Muscle & Fitness
	Other

Have you used other Universal Nutrition products in the past?:*

	Yes
	No

What other supplements do you use?:

Where do you buy most of your supplements?:*

	Internet
	Retail Store
	Gym
	Other

Limitations:
Offer good while supplies last. You must be 18 to receive a sample and have a mailing address within the continental U.S. Only one sample per household please. Universal Nutrition reserves to right to refuse any sample request at its sole discretion. Please allow 4-6 weeks for delivery.