H&S on TeenFX.com - Free Sample Registration Page.

Just complete this form to receive your free trial size (2 oz.) bottle of Head & Shoulders^® shampoo.

First Name:

^*

Last Name:

^*

Address:

^*

City:

^*

State:

^*

Zip:

^*

Country:

UNITED STATES

Birthday:
(month-day-year)

-- ^*

Email:

^*

Gender:

Female Male ^*

Telephone:

(optional)

^* required field

Do you have, or have you had a tendency toward any of the following conditions:

occasional light flakes

recurring dandruff

dry/itchy scalp

seborrheic dermatitis

none of these

How many times per week do you use Head & Shoulders?

Which Head & Shoulders shampoo would you like to receive (select one):

Classic Clean Shampoo

Classic Clean 2 in 1 Shampoo

Extra Fullness Shampoo

Smooth & Silky 2 in 1 Shampoo

Dry Scalp Care Shampoo

Refresh Shampoo

Intensive Treatment Shampoo

Important Information - Please note: We take great precautions to keep the information you share with us safe and private. We will not sell or give your personal information to other marketers without your express consent. However, from time to time, we would like your permission to send you free product samples, sneak previews of new products, or personalized offers or tips. We also may ask for comments on how to improve our product or programs. In order to do so, your information may be securely shared with our agencies, which perform these services on our behalf, or safely stored in countries other than where collected. You can easily stop this type of communication at any time. Visit URL: http://www.pg.com/privacy.htm for full details of our privacy policy.

Would you like to participate in programs like this from

Head & Shoulders?	yes	no
Other P&G Beauty products?	yes	no
Other P&G products?	yes	no
Other companies?	yes	no