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Receive up to $6.00
CASH !
Cash
Back for purchasing any combination of Aqua Splash 4-packs
Buy
(4) Four 4-packs and receive $ 2.00
cash back !
Buy (8)
Eight 4-packs and receive
$ 4.00 cash back !
Buy
(12) twelve 4-packs and receive
$
6.00 cash back !
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A) Include
your original cash register(s) receipt
showing the purchase of (4) four, (8) eight,
or (12) twelve 4-packs of any Aqua Splash
Flavors (must be original cash register
receipts)
B) Include this
mail-in rebate certificate, filled out
completely
C) Mail this form
to:
"Cash
Back Offer”
PO Box 0647 Oshkosh,
Wisconsin 54903 |
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Name:
____________________________
Address:
__________________________
City:
_____________________________
State: ______
Zip: __________
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**
Please allow 4 to 6
weeks for processing
**
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Tell
us something about you, and receive an additional
gift !
Marital Status -
[ ] Married
[ ] Single
[ ] live in partner
Household
Income - [ ] less than 30K
[ ] 30K to 50K [
] more than 50K
Level
of education - [ ] high school
[ ] some college [
] college degree
Please
rank your regular normal beverage consumption
from
a High of Six (6) to a Low of One (1)
(based
on average, how much for example: cans/bottles,
etc..) you consume per week)
Water
( )
Soda/Carbonated ( )
Milk ( )
Tea/Coffee ( )
Juices ( )
Other( ) |
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