Email Name Address City State Zip Code Phone Number 1. Do you currently use biodiesel? yes no If yes: B5 B20 B50 B100 If no, Proceed to Question #5 2. What has your experience been? Excellent Good Fair Poor Please Explain: 3. How many gallons of fuel do you use per month? Proceed to question #8 4. If you're not currently using biodiesel what's holding you back? Price Availability Don't have a diesel vehicle Need more information Other: 5. If you decide to use biodiesel, would you use: B5 (5% biodiesel, 95% petroleum diesel) B20 (20% biodiesel, 80% petroleum diesel) B50 (50% biodiesel, 50% petroleum diesel) B100 (100% biodiesel) 6. If you decide to use biodiesel, how many gallons would you use per month? 7. If you are using biodiesel, or considering it, what vehicle do you drive (Make / Model / Year)? 8. Which of the following club services seem appealing to you: Biodiesel education program (learn about biodiesel and its use.) Biodiesel vehicle inspection service Diesel vehicle purchasing service (eg: Mercedes, VW-TDI, Mini Cooper, Audi A2, diesel SUVs, smaller pickup trucks, etc.) 9. Please add any comments or questions you may have for us in the space provided, and thanks for your help.