Holy Organic!---Free Gift Survey

Due to overwhelming response, we now only offer our free gift to customers who purchase a minumum order of $5.00 & who fully fill out the survey. Thanks for your support!

Fill out this short survey and receive a free gift!

1. How did you learn about Holy Organic! ?

2. What other organic products or services would you be interested in purchasing?

3. Do you recommend any other companies or organizations with which we can trade links or share info?

4. What do you like most about this site or this catalog?

5. What about this site or catalog should change?

6. Any other comments?

7. Choose any of the following (more than 1 is fine):

I want to be on your snail-mail list to get a free print catalog.

I want to be on your e-mail list for info & updates.

Please take me off your snail-mail list.

Please take me off your e-mail list.

Please send a catalog to the following friend or family member:

FIRST NAME:

LAST NAME:

ADDRESS:

APT:

CITY/TOWN:

STATE/PROVINCE: ZIP/CODE:

COUNTRY:

PHONE: ( ) - FAX: ( ) -

E-MAIL:

SEND MY FREE GIFT TO:

FIRST NAME: *

LAST NAME: *

ADDRESS: *

APT: *

CITY/TOWN: *

STATE/PROVINCE: * ZIP/CODE: *

COUNTRY: *

PHONE: ( ) - FAX: ( ) -

E-MAIL:

Thanks!! E-mail, fax or snail-mail this survey to us
with your order of $5 or more and we'll ship you your gift!
Don't forget to fill in your name & shipping address.