Who is registering for Choose Fresh?
*
I am registering myself as a client of KSM.
I am registering for someone else who is a client of KSM.
Client Name
*
First Name
Last Name
KSM Client Number
*
Client Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Client Email Address
An email receipt will be sent to this address.
If you are registering for a KSM client, please provide your information below:
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Which program are you choosing?
*
Choose Fresh ($25)
Choose Fresh Plus ($35)
Choose Fresh Food Selections
Please select your choice of milk:
*
2% Milk (4L)
Almond Milk (946ml) x 2
Soy Milk (946ml) x 2
Cheese x 1 (one protein week) & Butter x 1 (other protein week)
None
Please select between eggs or tofu:
*
Egg (1 dozen)
Tofu (400g) x 2
None
Please select your choice of protein:
*
Halal Chicken Quarters (approx. 5lbs)
Halal Ground Beef (up to 2lbs)
Salmon x 4
Vegan Alternative x 2
None
Choose Fresh Plus Food Selections
Please select your choice of milk:
*
2% Milk (4L)
Almond Milk (946ml) x 2
Soy Milk (946ml) x 2
Cheese x 1 (one protein week) & Butter x 1 (other protein week)
None
Please select between eggs or tofu:
*
Egg (1 dozen)
Tofu (400g) x 2
None
Please select your choice of protein #1:
*
Halal Chicken Quarters (approx. 5lbs)
Halal Ground Beef (up to 2lbs)
Salmon x 4
Vegan Alternative x 2
None
Please select your choice of protein #2:
*
Halal Chicken Quarters (approx. 5lbs)
Halal Ground Beef (up to 2lbs)
Salmon x 4
Vegan Alternative x 2
None
PROCEED TO PAYMENT
Should be Empty: