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Take Our Survey and Get One Month's Supply of NEI FREE! Pay $1.50 for postage and handling only

Thank you for your interest in NEI products. We invite you to participate in our short survey to receive your free samples of Nature’s Essential Ingredients Almond Soy Shampoo and Almond Soy Moisturizing Conditioner with Mint. That's enough product to shampoo and condition your hair once a week for 4 weeks.

All personal information provided to us will remain strictly confidential. Upon the completion of your order, your samples will be mailed to you within 7 to 10 business days.

First Name:

Last name:

Address:

City:

State:

Zip Code:

Phone:

* (ie: XXX-XXX-XXXX)

Email:

Please start the survey now by clicking on the response buttons below.

How familiar are you with Nature's Essential Ingredients?
Never heard of it
I am aware but have never used it
I’ve used it before
I use it sometimes
I use it regularly

How did you first hear about Nature’s Essential Ingredients?
Internet/Web Search
Word of Mouth/Friend/Relative
Salon
A NEI Event or Party
Community Event
Haven't heard of it before
Not sure
Other, please specify:

Do you currently use any Nature's Essential Ingredients products?
Yes No

If Yes, please select all that apply.
Almond Soy Shampoo
Almond Soy Moisturizing Conditioner with Mint
Beta-Carotene Conditioning Treatment
AquaSilk Leave-In Conditioner
Silk Almond Serum with Jojoba

How likely would you purchase Nature’s Essential Ingredients products in the next 3 months?
Extremely likely to purchase
Very likely to purchase
Somewhat likely to purchase
Unlikely to purchase
Very Unlikely to purchase

Would you recommend Nature’s Essential Ingredients products to anyone in the future?
Definitely would recommend
Probably would recommend
Not sure
Probably would not recommend
Definitely would not recommend

Please select the category that best describes your hair texture and type:
Naturally Curly Naturally Wavy Naturally Straight Naturally Kinky/Afro

Please select the category that best describes your current hairstyle:
Straight/Relaxed
Color Treated/Relaxed
Natural
Braids/Cornrows
Twist/Locs
Wavy/Texturized
Other, please specify:

Do you suffer from any of these common hair and scalp problems? Please select all that apply.
Split Ends	Breakage Around Hairline	Thinning
Dull, Dry Hair	Brittle Ends	Chemical Damage
Thermal Damage	Dry Scalp	Itchy Scalp
Dandruff	Flaking	Lack of Shine
Hair Won’t Hold A Style	Other, please specify:

Please select the category that includes your age.
Under 18
18-24
25-34
35-44
45-54
55-64
65 or Above
Prefer not to answer

Please click on the Finish Survey button to complete this Survey to receive your samples of Nature’s Essential Ingredients Shampoo and Moisturizing Conditioner. *Offer good while supplies last.