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Breast Pump - March 2019
Free Product Testing Opportunity: Breast Pump
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1.
Please provide us with the following information:
(Required.)
Name
Address
City/State
Zip/Postal Code
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2.
Please provide us with your email address:
(Required.)
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3.
Please tell us the age of your children:
(Required.)
Under 1 years old
1 - 4 years old
5-9 years old
10+
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4.
Are you currently nursing your child?
(Required.)
Yes
No
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5.
Are you currently using a breast pump?
(Required.)
Yes
No
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6.
What brand of pump do you currently use?
(Required.)
Spectra
Medela
Avent
Lansinoh
Evenflo
Other (please specify)
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7.
What features do you look for when purchasing a breast pump? Please select all that apply.
(Required.)
Electric
Dual Pumping
LCD Display
Memory function
Ability to use with different bottles
Easy to clean
Travel friendly
Multiple pumping and stimulation levels
Other (please specify)
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8.
What brand do you seek when you are purchasing bottles for your child? Please check all that apply.
(Required.)
Avent
Munchkin
Playtex
Tommee Tippee
Nuk
Other (please specify)
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9.
Which of the following bottles do you currently use?
(Required.)
Philips AVENT Natural Baby Bottles
Nuk Simply Natural Baby Bottles
Dr. Brown's Original Baby Bottles
MAM Anti-Colic Baby Bottles
Munchkin Latch Baby Bottles
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10.
Would you like to be considered for this opportunity?
(Required.)
Yes
No
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11.
Would you like to be notified of future testing opportunities?
(Required.)
Yes
No
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12.
Please make me a member of the PTPA community so I can keep getting opportunities to test free products. I understand that I will receive new opportunities via e-mail from PTPA Media Inc.
(Required.)
Yes
No
*
13.
To complete your PTPA registration, you must read and agree to our
terms of use
.
(Required.)
I agree to PTPA's Terms of use
