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Welcome To Fill-UpAmercia.com
 

Thank you in advance for taking the time to complete our short questionnaire. 

We hope your shopping experience was a good one.

Register for your FREE gas certificate!
Limited to ONE FREE CERTIFICATE PER HOUSEHOLD
or PER DEALER VISIT in a 30 day period.  THANK YOU!

  1. Were you greeted professionally at the dealership?
    Yes    No 
     

  2. Are you in the market for a new vehicle?
    Yes    No
     

  3. If YES, did you buy?
    Yes    No 

  4. If NO,  are you in the market for a vehicle in the next:
    3-6 months    6-12 months    12+ months 

  5. Would you consider buying a car from the dealership where you received your   fillupamerica.com ticket?
    Yes    No    Possibly 

  6. Rate your overall experience at the dealership.
    Great    Good    Fair    Ok    Bad 

  7. Enter your dealer promotion code:
     

  8. If you could change something at this dealership what would it be?:
     

  9. Please enter the date you are registering:

  10. Please enter the expiration date of your certificate:

Where do we send your ticket?
You will receive your certificate via the us postal service in 4-7 days. We are not responsible for lost or late mail.
None of your information will ever be sold or used for un-authorized spam or any solicitation.

Full Name   Address  
Email   City  
Phone   State  
  Zip Code  

Got any comments about your experience?


Please read these terms and conditions of use before using this site. By continuing to access or use this site, or any service on this site, you signify YOUR ACCEPTANCE OF THESE TERMS AND CONDITIONS OF USE.


Click Here to signify your acceptance.
Limited to ONE FREE CERTIFICATE PER HOUSEHOLD
or PER DEALER VISIT in a 30 day period  - THANK YOU!