Please Note: If you have reported or plan on reporting the individual weight loss of any of the members of this group on this website, then you should not include them as participants in this group submission. Please Note: If you have included or plan on including this individual's weight loss within a group weight loss submission on this website, then you should not submit this person as an individual.

Please fill out the following:
Your Name*
Your Distributor ID*
Your Distributor/Team Level
Distributor Email Address*
Weight-Loss Month
Group NameIndividual's Name*
Number of Participants Who Lost Weight in Your Group*
Number of Pounds Lost During Month for All ParticipantsNumber of Pounds Lost During Month*
Your Country*
Business Method(s) for Reported Weight Loss (check all that apply)

*Required