FREE MILK POWDER SAMPLE FOR YOUR CHILD’S CATCH-UP GROWTH! Question Title * Which formula milk brand is your child currently consuming? Pediasure Gold S-26 Gold S-26 Gold Ascenda NAN OPTIPRO Enfagrow Pro A+ Friso Gold Similac Gain Aptamil Gold Other (please specify) Question Title * S-26® Gold ASCENDA™ is scientifically formulated to support catch-up growth for children falling behind the growth curve or are taking insufficient nutrients due to picky eating behaviour.Do you have concerns about your child falling behind the growth chart or displaying picky eating behaviour? Yes No Question Title * S-26® Gold ASCENDA™ contains Sphingomyelin and DHA. DHA supports your child’s brain development. Do you have concerns over your child’s learning and development? Yes No Question Title * Delivery Details for S-26® Gold ASCENDA™ Sample Parent's Name (as per NRIC) Child's Name Child's Date of Birth House/Block Number Street Name Unit No. Postal Code Email Address Contact Number Question Title * Terms and Conditions By submitting this membership form, I consent to the Terms & Conditions of Wyeth Nutrition website and Terms & Conditions of the Wyeth Nutrition Parenting Club (the “T&Cs”). I also agree that Wyeth Nutrition (Singapore) Pte Ltd (Wyeth") may collect, use and share my personal data (“Personal Data”) with its related and affiliated corporations (“Nestlé Group”) for the purpose of creating and administering my account and membership and for the purposes as set out in the Privacy Notice and the T&Cs. I agree that the Nestlé Group (as defined below), including Nestle Singapore (Pte) Ltd, Wyeth Nutrition (Singapore) Pte. Limited (“Wyeth Nutrition”) and CPW Singapore (Pte) Ltd, may contact me via telephone calls and messaging for promotional and marketing purposes in relation to products and services of Wyeth Nutrition and the Nestlé Group.* I also agree to receive promotional and marketing materials on the products and services of Wyeth Nutrition and the Nestlé Group, including by email and mail, and in accordance with the Privacy Notice and Parenting Club T&Cs.* I have read Mummys Market Terms and Conditions and agree to the Privacy Policy. I consent to Mummys Market and partners to contact me for marketing of their products and services, and provide me with marketing, advertising and promotional material and information. Terms and Conditions apply. Full terms and conditions are available at www.wyethnutrition.com.sg.Wyeth Nutrition Parenting Club is for residents of Singapore only. This sample request ends on 30 Sep 2022 and is limited to first time sample request for children aged 1 to 7 years old. Limited to the first 1,000 sign-ups only. Question Title * Newsletters and Offers I would like to receive information on S-26® GOLD product information and offers. I would like to receive information on Ascenda™ product information and offers. I would like to receive information on PROMAMA® product information and offers. I would like to receive information on Enercal® Plus product information and offers. Redeem!