Budget $aver® Survey/Customer Feedback If you would like to share additional comments or have any questions, please let us and your local retailer know. We thank you for your interest in our products and welcome you input. If you provide us with your name and address, we will send you a coupon for you to use next time you purchase a Budget $aver® product. Providing information is optional.

Name:
Organization:
Street Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
Email:
Gender: Skip - Male - Female
Number of people living in your house:
Number of children living in your house:
Have you purchased Budget $aver® Twin Pops before: Skip Yes No
Will you purchase Budget $aver® Twin Pops again: Skip Yes No
Why or why not:
Where did you purchase Budget $aver® Twip Pops:
Where else would you like to purchase Budget $aver® Twin Pops:
What was the retail price you paid:
What products do you purchase most frequently: Select as many as you like ( ctrl - click ) Skip Assorted Tropic Banana Banana/Fudge Cream Cream Bars Sugar Free Assorted Club Box
Number of products your household purchases per month: Skip 0-1 2-3 4-5 6-7 8-9 10+
What are your favorite Budget $aver® Twin Pop products: Select as many as you like ( ctrl - click ) Skip Assorted Tropic Banana Banana/Fudge Cream Cream Bars Sugar Free Assorted Club Box
Are there any flavors you would like to see added:
Any additional Comments: