Wufoo
Soylent Trial 1
Thanks for your interest in being a trial subject!
Unfortunately, we have reached our limit for initial Soylent trial participants. You can still apply, and we may have further trials in the future, but please don't be disappointed if you don't get contacted.
Currently the only guaranteed way to try Soylent is to preorder at http://soylent.me
Name
*
Email
*
Age
*
City, Country
*
Sex
*
Male
Female
Race
Weight (lbs)
*
Height (ft, in)
*
Diabetic?
*
No
Type 1
Type 2
Tell me about your current diet
Tell me about your level of Physical Activity
Any chronic illnesses, allergies, or deficiencies?
What is the reason you would like to try Soylent?
How Much Quantifiable Testing are you willing to perform?
General Health and Wellness Report
Cognitive Tests
Blood Tests
Blood Tests + Cognitive Tests
Experimenting aside, what percentage of meals do you imagine you would prefer Soylent to purchasing or preparing regular food?
0%
1-25%
26-49%
50-80%
81-95%
>95%
Have you had your genome sequenced (e.g. 23andme.com)?
No
Yes but unwilling to share results
Yes and willing to share results
Anything else you'd like me to know
Do Not Fill This Out
Wufoo
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