You can always press Enter⏎ to continue
Burning Daily Club,
Please fill out our survey for 20% OFF!
9
Questions
START
1
Full Name (First and Last)
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
2
Email Address
*
This field is required.
example@example.com
Previous
Next
Submit
Press
Enter
3
How do you burn daily? (Multiple Choice)
*
This field is required.
Edibles
Flower (Pipes, Bongs, Pre-rolls, Blunts)
Disposable Pens
Concentrates (Wax, Dabs)
510 Cartridges
Previous
Next
Submit
Press
Enter
4
What is your age range?
*
This field is required.
21-30
31-40
41-50
51-60
61+
Previous
Next
Submit
Press
Enter
5
How did you hear about Burning Daily? (Choose one)
*
This field is required.
Online Ads
Recommended by friends/family
Search Engine (Google, Yahoo, etc.)
Social Media (Instagram, etc.)
Other
Previous
Next
Submit
Press
Enter
6
Would you be interested in a loyalty program?
*
This field is required.
A program where you buy from Burning Daily and earn points which will go towards your future purchases.
Yes
No
Other
Previous
Next
Submit
Press
Enter
7
Would you be interested in a monthly subscription box?
*
This field is required.
Flower, edibles, vapes - a variety of products sent to you monthly.
Yes
No
Other
Previous
Next
Submit
Press
Enter
8
What products would you like to see from Burning Daily? (Multiple Choice)
*
This field is required.
More Edibles
More Flower (Pre-rolls, Blunts, Eighths)
More Disposable Pens
More 510 Cartridges
More Pet CBD
CBD Products
Concentrates (Wax, Dabs, Shatter, etc.)
Merch
Smoking Accessories
Other
Previous
Next
Submit
Press
Enter
9
Notes/Feedback/Suggestions
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
9
See All
Go Back
Submit
