Share Your Life Experience

1. Your First Name:

2. Your City/State:

3. Email Address:

4. Share your IMMUSIST™ Life Experience:
     Experience should not be too short or too long, aim for between 20 to 500 words.

For your privacy and security, do not enter any of your personal information i.e., fulll name, physical/mailing address, telephone numbers, email addresses, website addresses or other personally identifiable information into the Share your IMMUSIST™ Life Experiences text area.

5. Release:
In order to be able to actually use your Life Experiences, we need you to realize that by submitting your Life Experiences, you hereby grant IMMUSIST™, its affiliates, subsidiaries, assigns, licensees and legal representatives the irrevocable, perpetual, worldwide right to use, reproduce, edit, store, sublicense, distribute, have distributed, create derivative works, publicly and privately promote, display, and perform, in any medium, by any means of delivery, for commercial, promotional or other ppurposes without remuneration to you. The IMMUSIST™ Privacy Policy and Terms and Conditions explains the practices that apply to your information when you submit Life Experiences to IMMUSIST™.

6. By clicking "Submit" you are agreeing electronically to the terms of this policy and giving IMMUSIST™ or its parent or successor the equivalent of written signature for legal purposes.

Thank you for sharing your Life Experience! We believe it could inspire, motivate and benefit many!