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———— This Sweepstakes is only for Adult Tobacco Consumers ————
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Electronic Signature
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Please enter your name and address as they appear on your driver's license or official ID:
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First Name
required
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Last Name
required
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Suffix
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required
I certify that I am a legal age
tobacco consumer and that I want to receive products, offers, premiums,
coupons and/or information from tobacco companies. I understand that
giving false information in order to accept these offers may constitute
a violation of law. |
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Address
required
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Apt/Lot #
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City
required
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State
required
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Zip Code
required
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Gender
required
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Birthday
required
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E-Mail Address
required
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Phone Number
required
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required
I would like to receive emails,
including commercial emails, about special offers and/or other
information from R. J. Reynolds Tobacco Company and its tobacco brands.
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What ONE brand of CIGARETTES do you smoke most often?
required
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What CIGARETTE brands have you purchased for yourself recently?
required
— Select up to 3 —
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What OTHER TOBACCO products have you purchased for yourself in the last 6 months?
— Select up to 3 —
SNUS:
Camel SNUS
Marlboro SNUS
Skoal SNUS
Other SNUS
Moist Snuff or Dip:
Copenhagen
Kodiak
Grizzly
Skoal
Other Moist Snuff or Dip
Dissolvable Tobacco:
Camel (Orbs, Sticks or Strips)
Ariva
Stonewall
Other Dissolvable Tobacco
Other Tobacco Products:
Chewing tobacco
Cigars
Little Cigars
Pipe Tobacco
None of the Above:
None of the Above
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How would you prefer for us to communicate to you in the future?
required
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Additional Information
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Please provide this additional information to assist us with our verification process:
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Previous Address
required
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Apt/Lot #
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Previous City
required
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Previous State
required
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Previous Zip
required
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