Load Accessibility Friendly Version
Please fill in the following information from your receipt.
Store Phone Number: Input the first three digts of Store Phone Number - Input the digits after the first dash - Input the digit(s) after the second dash
Date: VisitDateMonth -- 010203040506070809101112 / Day -- 01020304050607080910111213141516171819202122232425262728293031 / Year -- 2223
Time: Hour -- 010203040506070809101112 Minute -- 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 AM or PM -- AMPM
I do have a survey Entry ID on my receipt.
