Vibrant Ambassador Application
RequiredRequired Question(s)
Required 1.

What level of commitment are you applying for?

Vibrant Health Ambassador
Influencer
Required 2.
Please enter the information indicated below.

First Name:
Last Name:
Job Title:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

Required 3.
Occupation:
 

50 characters left.
4.

Certifications/Career Highlights:

 

50 characters left.
Required 5.

What Vibrant Health products do you use and how have they helped you? 

 

350 characters left.
Required 6.

What are the top 3 things you love about Vibrant Health as a company?

 

350 characters left.
Required 7.

Do you now or have you ever worked for or represented Vibrant Health in a professional setting? (i.e. demo rep, sales rep, employee)

Yes
No
  • Comment:

  • 500 characters left.
Required 8.
Tell us a little about yourself:
 

350 characters left.
Required 9.

Why do you want to be a Vibrant Ambassador? What makes you stand out among the crowd?

 

1000 characters left.
Required 10.

Do you have a blog and/or website? Please include them here:

 

50 characters left.
Required 11.

How often do you use the following social media platforms?

 Hourly Daily Weekly Monthly Never 
Facebook
Instagram
Pinterest
Twitter
LinkedIn
Google+
YouTube
  • Comment:

  • 500 characters left.
12.

Facebook URL:

 

50 characters left.
13.

Twitter Handle:

 

50 characters left.
14.

Instagram Username:

 

50 characters left.
15.

YouTube URL: 

 

50 characters left.
16.

Pinterest URL:

 

50 characters left.
17.

Google+ username

 

50 characters left.
Required 18.

How often are you asked for your advice about different products you take?

Never
Almost Never
Sometimes
Fairly often
Very often
  • Comment:

  • 500 characters left.
Required 19.
What is your t-shirt size?
Men's Small
Men's Medium
Men's Large
Men's X-Large
Women's Small
Women's Medium
Women's Large
Women's X-Large
20.

Is there anything else you'd like us to know?

 

350 characters left.
IMPORTANT: By submitting this application you are agreeing to the terms and conditions of the Vibrant Ambassador program offered by Vibrant Health.  Your online activity is subject to review and any use of profanity or misinformation could be cause for termination of your ambassador status. Free product is subject to approval based on inventory and not guaranteed.