E15 Usage Survey
We are asking Imperial, NE area residents to complete the following survey regarding E15 fuel usage. One survey participant will receive a $100 fuel card so please make sure to complete the information on how we can contact you.
*Denotes required field.        One Entry Per Person


 
Name*  
Phone Number*  
Email Address*  
If available in Imperial, would you purchase E15 fuel?*   Yes    No  
If you would purchase E15 fuel, how many gallons would you use per month?* 
If no, reason for not purchasing E15* 
Main factor for fuel purchase decisions*   Price    Vehicle Performance    Mileage    Other  
If you selected other for a factor in the fuel you purchase, please list other reasons.* 
Please type the text in the box.


   
  

 
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