BECOME AN AGENT

Home
ABOUT US
OUR PRODUCTS
NEWS & VIEWS
TESTIMONIALS
- SUBMIT A TESTIMONIAL
PET HEALTH
CONTACT US
- CHAT FORUM
BECOME AN AGENT

please complete the form to become an agent/reseller:

PLEASE NOTE THAT YOU WILL BE REQUIRED TO COMPLETE A SHORT MULTIPLE CHOICE QUESTIONNAIRE TO QUALIFY AS AN AGENT. PLEASE SCROLL DOWN TO COMPLETE THE QUESTIONNAIRE.

Name *

First

Last

Email *

Comment/Question *

YOUR PROVINCE: *

Western Cape Eastern Cape Northern Cape North West Free State Kwazulu Natal Gauteng Limpopo Mpumalanga

Submit

Questionnaire for our agents

SECTION 1:

1. What is Hemp ? *

Cannabis Psychoactive drug From the Cannabis Sativa-L plant (Not Psychoactive) Mushroom Type, causes a High feeling Something that you wear

2. Where does Hemp work Primarily? *

In fighting Inflammation On Pain receptors In the garden

3. Does Hemp contain a Natural SPF? *

Yes No

4. Does Hemp interfere with any Chronic Medication? *

Yes No

* Indicates required field

Your Email Address *

Submit

SECTION 2:

5. Hemp could assist with ? (Pick the correct one) *

Arthritis Keeping me warm Helping me get dressed

6. Is Hemp Given to Children? *

Yes, age 3yrs and up No Yes, Only from 18 years and up

7. Can Pets take Hemp? *

Yes No

8. Hemp Cream is very good for Skincare disorders? eg. Psoriasis, Eczema, burns...etc? (Available at PicknPay Pharmacies) *

Yes No

* Indicates required field

Your Email Address again please: *

Submit

SECTION 3:

9. List the 5 De Terra products: *

10. Does Hemp Disrupt Pregnancy? *

Yes No

11. "Hemp is the Most ............. , Natural, ....................Product known to us" *

12. Who owns De Terra Skin & Beauty? *

* Indicates required field

Your Email for a last time please: *

Submit

Create your own unique website with customizable templates.

Home
ABOUT US
OUR PRODUCTS
NEWS & VIEWS
TESTIMONIALS
- SUBMIT A TESTIMONIAL
PET HEALTH
CONTACT US
- CHAT FORUM
BECOME AN AGENT