*Indicates a required field.
To submit your before and after photos, use the browse buttons to select the .jpg or .gif photos you wish to submit from your hard drive. Each photo should be no larger than 1MB in size.
You must be 18 years of age or older to submit a photo. If you are a minor, please
have your parents submit a photo for you. We will notify you if you are selected
for further consideration to appear in one of our Proactiv advertisements. By submitting
your photos and the completed questionnaire to us, you authorise us to disclose
both the photos and the information contained in your completed questionnaire to
our production consultant(s) for the purpose of determining whether you will be
selected to appear in one of our Proactiv advertisements. Other than for the purpose
stated above we will retain your photos and completed questionnaire on file and
will not disclose or use your photos or the information contained in your completed
questionnaire for any other purpose without your express written permission. Please
note that we do not return photos or completed questionnaires and all photos and
completed questionnaires submitted to us become the property of Guthy-Renker Australia
Pty Limited.
- Please enter all required fields
- Your first name is required
- Your last name is required
- Your address is required
- Your suburb is required
- Your state is required
- Your postcode is required
- Please enter a valid email address
- Your email addresses do not match
- Please enter a 10 digit phone number (include an area code)
- Please enter a valid age
- Please select a gender
- Please answer all questions
- Please enter the date your Before Photo was taken
- Please select a Before Photo to upload