Welcome to {{hidden_brand}} {{hidden_format}} Survey!
Thank you for your participation. This survey has ended.
 
Did you or anyone in your household try the {{hidden_brand}} {{hidden_format}} you received with your {{hidden_delivery}}? *

     
 
Are you or anyone in your household planning to try the {{hidden_brand}} {{hidden_format}} you received with your {{hidden_delivery}} within the next 30 days? *

     
 
Prior to receiving the {{hidden_brand}} {{hidden_format}} with your {{hidden_delivery}}, how likely, or unlikely, were you or anyone in your household to purchase {{hidden_brand}} in the near future? *


 
Since receiving the {{hidden_brand}} {{hidden_format}} with your {{hidden_delivery}}, how likely, or unlikely, were you or anyone in your household to purchase {{hidden_brand}} in the near future? *


 
Since receiving the {{hidden_brand}} {{hidden_format}} with your {{hidden_delivery}}, have you or anyone in your household already purchased {{hidden_brand}}? *

     
 
Do you or does anyone in your household plan on purchasing {{hidden_brand}} in the next 30 days? *

     
 
Have you shared your experience with a friend since receiving the {{hidden_brand}} {{hidden_format}} with your {{hidden_delivery}}? *

     
 
In which of the following ways have you shared your experience with a friend since receiving the {{hidden_brand}} {{hidden_format}}? *


 
Which form of advertising has the greatest influence on you, to buy the product that is being advertised? (Select your top choice) *


 
Do you have any comments on this {{hidden_format}}?
Please let us know here: *

 
About You!

Please enter the following information to complete your entry
 
First Name *

 
Last Name *

 
May we send you future updates about this product? *

     
 
Would you be interested in doubling your chances to win? *

If yes, on the next page you will have the option to share a message about {{hidden_brand}} {{hidden_format}} on your Twitter Profile to double your chances to win!
     
Thank you for submitting your response!

A winner will be selected {{hidden_winselectdate}}
CLICK HERE TO 2X YOUR CHANCES TO WIN!
Thank you for submitting your response!

A winner will be selected {{hidden_winselectdate}}
CLICK HERE TO PURCHASE!