Sorry this sampling program has already been filled.  We look forward to working with you in the near future!

 Thank you for your interest in the Snickers Marathon Bar sampling program. This program is specifically designed for participants between the ages 12-18 involved in youth sports and activities. Please provide as much information as possible and note that only youth sports and activities that are able to distribute a minimum of 500 samples by December 31, 2008 will be considered for this promotion. Please note that you will be notified within 2-3 weeks if your event qualifies.

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Personal Information First Name Last Name Primary Phone  Enter a valid phone number. Example: 123-456-7890 Email Address  Enter a valid email address. Example: name@company.com Address 1 Address 2 City State Select OneALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code Organization Information Organization Name Is your organiztion a middle school? Yes No Is your organiztion a high school? Yes No Organization Website (if applicable) Organization Activity (check all that apply) Football Basketball Baseball Volleyball Soccer Lacrosse Softball Cheerleading Parks and Recreation Boys and Girls Club Girl Scouts Boy Scouts Field Hockey Gymnastics Tennis Other If other, please list Organization's Primary City Organization's Primary State Select OneALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY What percentage of your participants are within the ages of 12-18? Select One10%20%30%40%50%60%70%80%90%100% Event/Activity #1 Information Event/activity Name Event/activity Date Type of event/activity Practice Tournament Game Camp Special Event League After school program Number of participants ages 12-18 at the event/activity Event/activity City Event/activity State Select OneALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Event/activity Zip Code Shipping Address for Event/Activity (if different from above) - NO P.O. BOXES PLEASE! Is this a residential address? Yes No Event/activity #2 Information Event/activity Name Event/activity Date Type of event/activity Practice Tournament Game Camp Special Event League After school program Number of participants ages 12-18 at the event/activity Event/activity City Event/activity State Select OneALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Event/activity Zip Code Shipping Address for Event/Activity (if different from above) - NO P.O. BOXES PLEASE! Is this a residential address? Yes No Event/activity #3 Information Event/activity Name Event/activity Date Type of event/activity Practice Tournament Game Camp Special Event League After school program Number of participants ages 12-18 at the event/activity Event/activity City Event/activity State Select OneALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Event/activity Zip Code Shipping Address for Event/Activity (if different from above) - NO P.O. BOXES PLEASE! Is this a residential address? Yes No Event/activity #4 Information Event/activity Name Event/activity Date Type of event/activity Practice Tournament Game Camp Special Event League After school program Number of participants ages 12-18 at the event/activity Event/activity City Event/activity State Select OneALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Event/activity Zip Code Shipping Address for Event/Activity (if different from above) - NO P.O. BOXES PLEASE! Is this a residential address? Yes No By submitting this application form you agree to distribute the Snickers Marathon Bar samples from June through December 2008 to participants ages 12-18 through event bags, registration packs, coaches distribution, etc., including but not limited to team sports, schools, community activities and athletic events. Yes No