Cost Centre: 7812

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1. Contact Details

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2. The Name of the store?

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3. Town/Cty

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4. Date of Activation

Date

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5. Time of Activation

Time
Time

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6. Where were you positioned in the store

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7. Average Age of people who sampled the products

0 Years 50 Years 100Years
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i We adjusted the number you entered based on the slider’s scale.

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8. How many of each ULTRA low-carb sample were given

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9. How many of each ULTRA low-carb packs were sold

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10. Please give 5 recurring comments or interesting feedback on the products or flavours

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11. We value your feedback on the demonstration and how you thought the sampling went.  Please provide feedback on the store and support given.

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