Consent Form:

I, __________________________________________, hereby consent to be a participant in the

Consumer Preferences Towards Lays Chips Questionnaire and understand that the purpose of
it is to understand the knowledge base, attitudes and beliefs of consumers with regards to Lays
chips and its issues. I also understand that the questionnaire will be used to further the
understanding of the researchers and hopefully help formulate a general consensus to be
provided to the company.
I acknowledge that:
Any information I provide will be strictly anonymous to the public.
Any individual information I provide will be kept confidential and will never be released to
the public.
Any information I provide will be used for research purposes only.
I am free to withdraw from this study at any time without adverse consequences and any
information provided will be not be used.
Signed___________________________________

Date_____/_____/ 2009

I wish to obtain a copy of the results of this questionnaire

Please send to:
Address: ____________________________________________ Post Code: ________
Email: _______________________________________________________________
Contact Phone Number: (__) _____________________________________________