Please complete the following form to pledge your support and join our mission in helping us reach 1 million people annually.

1. Personal Information

(Select your primary role or area of expertise)

—Please choose an option—Fitness InfluencerPersonal TrainerDoctorNurseNutritionistDietitianPoliticianHealth EducatorPublic FigurePhilanthropistEntrepreneurInvestorArtistOther (Please specify)

Social Media Handles (If applicable):

2. How Would You Like to Contribute?

I pledge to support ShrinkBelly's Diabetes Awareness Program in the following ways (check all that apply):

Promote Diabetes Awareness on Social Media: Share ShrinkBelly’s educational content and awareness campaigns with my followers.Host/Participate in Educational Workshops or Webinars: Volunteer to speak or host sessions on diabetes awareness, nutrition, or fitness.Offer Free or Discounted Services: Provide health services, such as fitness training, medical consultations, or nutrition counseling, to individuals in need.Organize or Attend Community Events: Help plan or participate in ShrinkBelly’s community health events and diabetes screenings.Financial Contributions/Investment: Provide financial support to fund diabetes education programs, glucometer donations, free screenings, or other activities.Collaborate on Research or Public Policy Initiatives: Partner with ShrinkBelly on research efforts or advocacy for diabetes prevention in public health policy.Sponsor Health Products or Equipment: Donate glucometers, fitness equipment, or other health-related products to help individuals manage their health.Engage in Public Speaking Events: Advocate for diabetes awareness at local or national events, encouraging preventive action.Other Ways to Help (Please specify):

3. Expected Outcomes

What do you hope to achieve by participating in this collaboration?

4. Preferred Start Date for Collaboration

We would like to begin our collaboration on:

—Please choose an option—ImmediatelyWithin the next monthWithin the next 3 monthsOther (Please specify):

5. Additional Comments or Special Requests

How did you hear about us?*

ReferralAdFriendGoogleTikTokFacebookInstagramTwitterEmail

6. Agreement to Collaborate

I, agree, commit to collaborating with ShrinkBelly in its mission to raise awareness, prevent diabetes, and promote weight control. I will use my skills, platform, and/or resources to help reach 1 million individuals and make a positive impact on public health.

I accept all Terms and Conditions

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