JSJ Sales and Marketing | Feminine Hygiene Sample

Win a Box of Kotex Tampons/Pads

We are looking for women ages 18-49 to answer a couple questions about their feminine hygiene routine. Participants will have a chance to win a free 5-unit box of Kotex® pads or tampons. US residents only.

Simply fill out the form below and click "Submit". Fields marked with a red asterisk (*) are required.

Basic Information.

* First Name:		* Last Name:
* Email Address:
* Street Address:
Address Line 2:
* City:		* State:
* ZIP Code:
In accordance with our privacy policy, your shipping information will be used only to ship your free gift. It will not be used for any other purposes.
Additional Shipping Instructions (eg. Leave with doorman, buzzer #, etc)
* Choose your Kotex® sample:

Additional Information.

* 1. Which product type do you typically use?

Pads / Liners
Tampons
Both / It Depends
Other

* 2. How happy are you with your current product(s)?

Extremely happy
Fairly happy
Not very happy
Not at all happy

* 3. Please check off any problem(s) you have with your products:

Leakage / Wetness	Uncomfortable
Expensive	Hard to Insert / Use
Other If "Other", please list:

* 4. Do you or have you ever used an ecologically friendly pad or tampon?

Yes
No
Unsure

* 5. Would you be willing to try an eco-friendly pad or tampon if it meant paying a slight premium?

Definitely
Probably
Probably Not
Definitely Not

6. If there was one thing you could change about your pad and/or tampon, what would it be?

* I am a woman aged 18-49 and I have read the terms.

I wish to join the JSJ Newsletter, full of great freebies like this one!

Copyright ® 2011 JSJ Sales and Marketing Inc. All Rights Reserved.
Kotex is a registered trademark of Kimberly-Clark Worldwide, Incorporated. This is an
independent study - JSJ Sales and Marketing is not associated/affiliated with Kimberly-Clark.