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* 1. Please enter your phone number. (A valid 10 digit phone number is required to participate in this survey and be eligible for the gift card. Employees or families of employees are not eligible to win the gift card.)

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* 2. Please enter your Something Extra number or card number that you enter at checkout.

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* 3. Please add the "Store Number" from the top of your receipt. If you can't find the store number, please decline the survey.

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* 4. Please enter the date you shopped:

Date
 
 7% of survey complete.
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