Questions marked with a * are required Exit Survey
Contact Information
* Marketer Name : 
Marketer Sold To# : 
CITGO Location # : 
* First Name : 
* Last Name : 
* Phone : 
* Email Address : 
Please tell us how you’ve been Fueling Good in your community during these tough times. 
* Who are you supporting? (i.e. general public, customers, first responders, specific organization, etc.) 
* What are you providing? (i.e. funds, food, discounts, etc.)
* What do you estimate is the monetary value (if applicable) or estimated amount raised? 
* Did you get local media coverage? (i.e. newspaper article, news spot, etc.)
Your survey responses will be shared with CITGO and processed in accordance with the CITGO Privacy Policy - www.citgoprivacy.com.