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Thank you for your interest in testing out Jergens Soothing Aloe Refreshing Moisturizer. Please fill out the following questions to enter and be a Shedoesthecity product tester. Don't worry, we value our privacy too; your email address and other contact information is being used only for this campaign and you will not be added to any lists without your consent. 
 
1.
How old are you?
Under 18
18-25
26-32
33-37
38-45
45+
2.
Please specify your gender:
Female
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3.
Contact info.

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
Postal Code: