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The


Join today ... It's FREE!


Join an exclusive group of valued consumers in a program that matches your individual, unique preferences with timely, relevant product offers and information.

Here Are Just A Few Of The Benefits:

  • It's FREE! No membership cards, no subscription fees, no points to accumulate.

  • Get advertisements and information customized to suit your profile.

  • Sign up for free newsletters, etc.

  • Participate in surveys and make your opinion count.

  • Easily ‘opt-out’ at anytime.

  • And lots more!!


This is a permission-based program, i.e. you only receive what you have signed up for. AK Insights manages and coordinates all communication with you ourselves, not individual companies, thereby ensuring your personal details are treated with the utmost confidentiality. The sole objective of this program is to provide you with valuable information, products and services. We DO NOT ask you to submit any financial information about yourself.

We are certain that you will soon recognize us as your trusted source for consumer information. Please take a moment to view the full details of our Privacy Policy.


Complete the form below to JOIN NOW!

(fields with an asterisk (*) are required)

*First Name:

*Last Name:

Address Line1:

Address Line2:

*City/Town/Region:

*Day Phone:

(Format = 123-4567)    Extension

Cell Phone:

*Email:

(if none, please type NONE)

*Gender:

Male  Female

*Date of Birth:                    *Year  (Format = XXXX)

Marital Status:

Ethnicity:

(for cosmetic & hair care product information only)

What are you hobbies?

Do you smoke?

Yes  No

Do you own a car?

Yes  No

Do you own a camera?

No   Digital  Film  Digital & Film

Do you have pets?

No   Yes  If yes, what

Do you play or watch sports?

No   Yes  If yes, what

Do you or family members have any of these:

Asthma Diabetes Allergies Hypertension Cancer Other

For Cancer & Other, please describe:

What is your favourite colour?

*Preferred format for email messages:

 HTML (i.e. text & images)  Plain Text

By submitting this form you agree to receive communication from AK Insights Ltd. on its behalf or that of its clients.

You also understand that you can unsubscribe at any time.

 

 

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Last updated on:

September 17, 2007 12:30 PM

 

Copyright © 2007. AK Insights Ltd. All rights reserved.