Subscription

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WHAT'S YOUR SUBSCRIPTION? *

3 months 6 months 9 months 12 months

* Your choice is for informational purposes and without commitment.

NAME *

First name *

Do you have an elevator? *

YES NO

Floor *

Can delivery be made in your absence? *

YES NO Give my parcel to the janitor

How many bottles of water do you drink a month?

10 20 30 More than 30

How many bottles of milk do you drink a month?

6 12 18 24 More than 24 I don't drink milk

How many cans of soda do you drink a month?

6 12 18 24 More than 24 I don't drink soda

Where would you like delivery?

At home in the office Both

I want delivery

Every 1st of the month Every 15th of the month Every 30th of the month

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