You've been asked to test a New and/or Improved Pure Ambiance Candle Co. product. Please complete the survey below within 30 days of receipt of your product. Thanks so much and we hope you enjoyed it!

**Please Note - not all questions will apply to your item. Feel free to skip those that do not apply.**

#1 - Category of test product:

Candles (including massage candles)
Bath & Body (soap, lotions, scrubs, etc.)
Home or Car Fragrance (tarts, oils, scent beads, etc.)
Other

#2 - Item Name:

#3 - Item Number (ex. C163SS):

#4 - Retail Price (if known):

#5 - Please rate the SCENT of the product:

Great
Okay
Not so great
Horrible :-(
My product was unscented

#6 - What did you like or dislike about the scent?

#7 - If your product was a CANDLE, how did it burn?

Even with a nice steady flame
Unevenly (wax pilled up on one side), but with a steady flame
Even with a low flame
Burned initially but was unable to re-light
Flame was too large
Burned itself out after being lit
N/A (My product was not a candle)

#8 - What did you like the most about your product overall?

#9 - What did you like the least about your product or what would you change about it?

#10 - Is the product a good value for the price?

Yes
No
I do not know the price of my product

#11 - How likely are you to purchase this product from us in the future?

Very likely
Somewhat likely
Neutral
Somewhat unlikely
Very unlikely

#12 - Would you recommend this product to someone you know?

Yes
No

#13 - Enter your email below if you would like to be added to our mailing list and receive valuable coupons, offers, and information (leave this section blank if you wish to remain anonymous):

We thank you once again for being a product tester!

~Pure Ambiance Candle Co., LLC~