Fill out this 1-minute survey and you may be chosen to participate in our home product testing studies. If you
qualify, we’ll contact you to arrange delivery of one of our organic pesticides for you to try.  After using
EcoSMART for about a week, please let us know what you think!  

Please note,  the first 500 qualifying consumers to reply will receive free product.  We run new studies on an
ongoing basis, so if you are not selected for the first study, you may qualify for the next!  So feel free to join,
but please don’t be disappointed if you don’t hear from us right away!
1.
Do you have a problem with any of the following pests?
Ants
 Roaches
 Crawling
Insects
(spiders, beetles &
other pest coming
from outside)
 Flying
Insects
(flies but not wasps/hornets)
2.
Do you use bug repellents like OFF! or other brands regularly?
Yes
 No
3.
Do you use herbicides like Roundup or other brands regularly?
Yes
 No
4.
Have you used home perimeter products like Ortho Home Defense in the past month?
No
Yes
5.
Have you had a pest management service come to your home in the past 6 months?
No
Yes
What is your email address?
Where shall we ship EcoSMART to you?
Demographic Information
this information will be used for classification purposes only and will not be disclosed
Age
 Children/Pets
living with you?
 Education
Residence
 Income
 Gender
Ethnicity
Caucasian
African American
Hispanic
Asian
Native American
ecosmart organic pesticide
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