NAME
COMPANY
ADDRESS 1
ADDRESS 2
CITY
STATE
ZIP CODE
PHONE
EMAIL

Feedback on the Labels For Literacy Program. The folowing is a series of questions to help us provide better service to you. Use the tab key to advance through possible answers. Use the shift key and the tab key combination to review previous answers. To make a selection, press the space bar. To remove a selection, press the space bar again.

1. How useful would a regular supply of free household product labels in Braille and large print be in your daily life? (check one)

Very useful
Somewhat useful
Not useful

2. What would be the more effective way for you to receive the free labels? (check all that apply)

Mail
Grocery Store
State Agency
Organizations of/for the Blind
Schools
Libraries
Doctor’s Office
Other (describe in comments below)

3. The packages will contain free labels for a variety of products. Please suggest the products which you would like to have included in the package: (check all that apply)

FOOD

Baby food

Bakery products

Baking mixes

Candy

Canned goods

Cereal

Condiments

Crackers

Frozen goods

Dairy products

Flavorings, spices

Meat Products

Nuts

Packaged cookies

Pastas

Rice and grains

Sauces

Snack foods

Soups

BEVERAGES

Alcoholic beverages

Carbonated beverages

Coffee and tea

Drink mixes

Energy, sports, health drinks

Juice

Drinking Water

OTHER

Baby supplies

Cosmetics

First aid

Food storage

Electronics

Cleaning Products

Music and videos

Pet products

Personal hygiene products

Please provide any additional comments in the space provided below including any specific product suggestions: