Store Request Submission Page

Can't find our wonderful products at your favorite store. Let them know by asking them to carry them for you and their other health conscious customers.

Just complete the form below and your request will be sent to the headquarters of your favorite store.

As a thank you for taking the time to complete this form we will mail you $1.00 in coupons to use on future purchases of our products.

Which Benefit Nutrition Cereal Do You Want Your Store To Carry?
Store Name Where You Want To Buy Our Cereal *
Store Street Address *
City *
State *
Zip Code *
Please provide us with your contact information.
Your First Name *
Last Name *
Street Address *
Apartment Number
City *
State *
Zip Code *
Your Email Address
Choose A Prepared Message To Send Or Create Your Own Below
If the prepared messages do not convey your needs or do justace for the passion you have for our cereals please feel free to write your personal message here.
Enter Your Personal Message To The Store Management Here
Please Enter The Black Text So We Know You Are A Real Person