http://offers.e-centives.com/contest/reg/survey.cfm

BUY: One package of ELECTRASOL 2-IN-1 TABS WITH JET DRY POWERBALL, and if for any reason you are not completely satisfied with our product, we will send you a coupon by mail good for any one ELECTRASOL product valued up to $3.99.

TO QUALIFY: Print and complete this form; enclose original proof of purchase or original UPC, and enclose the sales receipt for the ELECTRASOL 2-IN-1 TABS WITH JET DRY POWERBALL, dated between 9/12/04 and 10/31/04 with the purchase price clearly circled.

MAIL TO:
Electrasol 2004 Unbeatable Clean Offer
P.O. Box 1133
Grand Rapids, MN 55745-1133

Offer expires 10/31/04.