Mr. Clean Dirty Little Blogger Blast Survey

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* 1. Contact Information

Name: *

Company: *

Address 1: *

Address 2:

City/Town: *

State/Province: *

ZIP/Postal Code: *

Country: *

Email Address: *

Phone Number: *

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* 2. What is your PayPal email address?

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* 3. What is your Blog URL?

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* 4. How many Unique Monthly Visitors?

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* 5. How many Facebook Fans do you currently have?

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* 6. What is your Facebook URL?

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* 7. How many Twitter followers do you have?

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* 8. What is your Twitter URL

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* 9. For this campaign, you will be required to tweet a link to the Mr. Clean official campaign video FOUR (4) times and post it on Facebook ONCE (1). Compensation for this will be $25 paid via PayPal within 90 days of the close of the campaign. Are you willing to complete all tasks stated above during the assigned time frame?

Yes

No

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* 10. Please tell us why you think you would be a great fit for this campaign and how your tweet and shares would be unique.