Please Check all that apply

How did you first hear about Tommy's Naked Soda?

Friend or relative

Store display

Instore product demonstration

Event other than instore

How would you describe you most recent purchase of Tommy's Naked Soda?

Impulse- saw it and bought it

Planned ahead to buy it

Have never purchased it before

Where did you purchase Tommy's Naked Soda?

Store Name:      City:   

Who suggested/made the purchase decision?

Me

My spouse or significant other

My child

Other relative

Friend

Who consumed your most recent purchase of Tommy's Naked Soda?

Me

My spouse or significant other

My child

Other Relative

Friend

Where did you consume your most recent purchase of Tommy's Naked Soda?

At home

At work

At the store

At a party

Listed Below are the current flavors of Tommy's Naked Soda

Tried  Bubbling Black Raspberry Luscious Lemon Lime Optimal Orange Clearly Cream

Favorite Bubbling Black Raspberry Luscious Lemon Lime Optimal Orange Clearly Cream

Please list rate the following "attributes" in the order of why you purchased

"Tommy's Naked Soda" ("1" indicates most important")

1 2 3 4 5 6 It is clear

1 2 3 4 5 6 All natural

1 2 3 4 5 6 Made with cane sugar

1 2 3 4 5 6 Neat label

1 2 3 4 5 6 Good Flavors

1 2 3 4 5 6 Other

How many times a month do you drink Tommy's Naked Soda?

  times a month

Gender

Male Female

Age

Under 20 20-29 30-39 40-49 50+

Which flavor would you like to see next? ("1" indicates most interesting and "5" indicates less)

1 2 3 4 5 Root Beer

1 2 3 4 5 Pear Ginger Ale

1 2 3 4 5 Strawberry

1 2 3 4 5 Grape

1 2 3 4 5 Cherry

1 2 3 4 5 Cranberry

1 2 3 4 5 Peach

I would like Tommy's Naked Soda to know...

Please give us your mailing address so we can send you some Tommy's Stickers

(** Due to the overwhelming demand for stickers. Tommy's Naked Soda can only send

them out to people in the states where Tommy's is available. These states are MA, ME,

VT, NH, CT, RI, NY and PA. Also, please fill in all the fields. Thanks **)

First Name:      Last Name:   

E-Mail:    

Street or P.O. Address:   

City:       State:       Zip: