| Name |
|
| Address |
Street
1 |
|
| Street 2 |
|
| Town/City |
|
| State |
|
|
|
| Date of Purchase
|
|
| Model
Name |
|
| Serial
Number |
|
| Dealer Name |
|
| Dealer
City |
|
|
|
| |
Gender |
Age |
| Person who chose
product |
|
|
| Person who purchased
product |
|
|
| Person who uses product
most |
|
|
| The purchase can be
best described as |
|
| What
brand are you replacing with this
brand? |
|
| How long did you
consider buying this product before making the
purchase? |
|
| In what application
is this product going to be used? |
|
| Which best describes
your choice in audio equipment? |
|
| Why did you buy this
product? |
Reason1 |
| Reason2 |
| Reason3 |
|
|
| Which
of the following do you own or plan to
buy: |
Own |
Will Buy |
Brand |
| CD Player (Single
Deck) |
|
|
|
| CD Player (Multi
disc) |
|
|
|
| Tape
Deck |
|
|
|
| MIDI (integrated)
System |
|
|
|
| Stand alone
amplifier |
|
|
|
| Stand alone
speakers |
|
|
|
| Dolby Pro Logic
Processor |
|
|
|
| Dolby Digital (AC-3)
Processor |
|
|
|
|
|
| Which technologies
have you used / familiar with: |
|
| Date
of birth |
|
| Level of
education |
|
| Marital status |
|
| Occupation |
|
| Annual family income |
|
|
|
