REFRESHMENT SURVEY FORM
To help us better understand your refreshment choices please select your favorite refreshments from the list
below with a check mark. List any products not listed at the bottom.
SODA, JUICE, BOTTLED WATER CHIPS, CRACKERS, NUTS, CANDY, GUM, MINTS
___Coke COOKIES ___Almond Joy
___Coke C2 ___Peanuts ___Baby Ruth
___Diet Coke ___Honey Roasted Peanuts ___Butteringer
___Caffeine Free Coke ___Granola Bars ___Reece's Peanut Butter Cup
___Cherry Coke ___Sunflower Seeds ___Hershey
___Vanilla Coke ___Corn Nuts ___Hersheey Almond's
___Sprite ___Frito's Corn Chips ___Kit Kat
___Orange Crush ___Chees & Crackers ___Fast Break
___Root Beer ___Peanut Butter & Crackers ___Junior Mints
___Pepsi ___Wheat Crackers & Cheese ___York Peppermint Patties
___Diet Pepsi ___Potatoe Chips-Plain ___Twix
___Pepsi One ___Potatoe Chips-BBQ ___Twix Peanut Butter
___Mountain Dew ___Potatoe Chips-Baked ___Mounds
___Diet Mountain Dew ___Potatoe Chips Crunchers ___ M & M Plain
___Dr. Pepper ___Dorito's ___M&M Peanut
___Diet Dr. Pepper ___Pringles ___M & M Almond
___RC Cola ___Cheeto's ___Mars Bar
___Squirt ___Gardetto's ___Milky Way
___Diet Squirt ___Chex Mix ___Payday
___7 Up ___Pretzels ___Granols Bar
___Diet 7 Up ___Popcorn ___Snickers
___Bottled Water ___Cheese Popcorn ___Snickers Crunch
___Orange Juice ___Microwave Popcorn ___Snickers with Almonds
___Apple Juice ___Oreo's ___5th Avenue
___Grape Juice ___ Famous Amos Cookies ___Salted Nut Roll
___V8 ___Austin Brand Cookies ___3 Musketeers
___Snapple ___Lance Brand Cookies ___Mr. Goodbar
___Ice Tea ___Grandma's Big Cookies ___Whoppers
___Red Bull ___Juicey Fruit Gum
___Gatorade CAKES AND PASTRIES ___Double Mint Gum
___All Sport ___Ho Ho's ___Big Red Gum
___Twinkie's ___Breath Mints
___Honey Buns ___Rolaids
___Cup Cakes ___Halls Cough Drops
___Ding Dong's ___Lifesavers
___Brownie's ___King Sized Candy Bars
___Powdered Donuts ___Rice Krispei Treats
___Chocolate Donuts
Other Choices___________________________________________________________________________
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Company_____________ Contact Name_______________ Date___________
