| |
To
receive your welcome gift, please fill out the questionnaire. Your answers will allow
us to personalize your visit at Perfumes.com. |
|
| |
Your
wear perfume |
|
| |
|
|
 |
 |
 |
| |
Whom
do you buy perfume for ? (select all applicable items) |
|
| |
|
|
 |
 |
 |
| |
How
many perfumes do you own at this time ? |
|
| |
|
|
 |
 |
 |
| |
Which
perfume do you wear these days ? |
|
| |
Brand
: |
|
|
| |
Perfume
: |
|
|
| |
Other
perfume : |
|
|
| |
 |
 |
| |
Which
perfumes did you wear most often within the past 12 months ? |
|
| |
Brand
: |
|
|
| |
Perfume
: |
|
|
| |
Other
perfume : |
|
|
 |
 |
 |
| |
Do
you ? |
|
| |
|
Always
wear the same perfume |
|
| |
|
Switch
from one perfume to another |
|
 |
 |
 |
| |
How do you describe
the main style of your perfume ?
(do
not check more than 3 items)
|
|
| |
|
|
 |
 |
 |
| |
Do
you feel like a change these days ? |
|
| |
|
|
 |
 |
 |
| |
If
yes, select applicable choices |
|
| |
|
|
 |
|
 |
| |
How
much do you spend on perfumes annually ? |
|
| |
|
|
 |
|
 |
| |
Where
do you buy your perfume ? (check one) |
|
|
|
 |
 |
 |
|
First
Name:
|
|
|
| |
Last
Name: |
|
|
| |
Address
1: |
|
|
| |
Address
2: |
|
|
| |
City: |
|
|
| |
State: |
|
|
| |
Country: |
|
|
| |
Zip: |
|
|
| |
Email
Address: |
|
|
| |
Phone
Number: |
|
|
| |
How
did you find us? |
|
|
 |
 |
 |
| |
Before
submitting this form to enter the contest, please review the contest rules:
• Contest is limited to the lower 48 US states
• All parts of the form must be filled out for it to be valid
• You may enter only once. Multiple forms will be deleted.
• A valid address AND email address must be entered
• The actual perfume will be selected by Perfumes.com |
|
 |
 |
 |
| |
|
|
 |
 |
 |
| |
I
would like to :
|
|
| |
Receive personalized offers from brand names |
|
 |
 |
 |