udio
pecialists”
Thankyoufor your purchase. Weat PolkAudiofeel you arethe most important
personin our company. Yourfeedbackwill help us in our ongoingefforts to producefhefinest andmost
satisfying loudspeakeravailable.
129F
First Name:
Address: (Number and Street)
City:
Phone#:
Initial: Last Name: A
Apt #: ,
State: Zip Code:
E-mail Address:
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(Ewww
yournameOyourhost.com)
Dateof Purchase: Month1
Day
Store Name:
Whoinstalled this product?
1. q Self
2. q Professional 3. 0 Friendi Relative
Did the following reasons influence your purchase of
this Polk Audio product? yf No
1. PolkAudioReputation
2.
Easeof Use z
3. Appearance E
4. Recommendationof Dealer
5. Recommendationof Family/Friend :: :
6. MagazineReview q IY
7. Qualityof Sound
8. TechnicalSoecifications : :
9. Valuefor Piice
10. PriorExperiencewith PolkAudio i :
Wherehaveyou seen Polk products featured? (Checkall that apply)
1. q Magazineadvertisement 4. q In-store advertising
2. 0 Polkliterature
5.
q Someoneelse’s home or cal
3. 0 Magazinereview 6. q On-line computer bulletins
Whatother brands did you
consi$?;lCEFk
allthat apply)
1. q Noother brands
2. q Advent 14. 0 Kenwood
3. 0 Alpine 15. 0 Kicker
4.
q Altec 16. 0 MBQuart
5. q BostonAcoustics
17.
0 MTX
6. q Canton 18. q Pioneer
7. q Cerwin-Vega 19. q RockfordFosgate
8. q Clarion
20.
0 Sony
9. q Infinity 21. q Soundstream
10. q JBL bi
Jensen’ 22. q Other
11. q
In what automobile will this Polk Audio product be installed?
Make:
EXAMPLE:FORD
Model:
EXAMPLE:~MUiTiNG
Year:
EXAMPLE:1965
Yourgender:
1. Cl
Male 2. q Female
Yourmarital status: 1. q Married 2. q Single
Dateof m birth:
Month Day Yeal
Dateof birth (month/year) of the Otheradults and
children in your household:
Male Female , Male Female
16
17
18
19
20
21
22
7
!d7_1_~9i?~-( j 1 [ 1 1’
ModellocatedonUPCbarfoundon
productcarton(Seeexample)
lncludins vourself, what is the total number of people
living in your household?
(Examples:01.02, 03,04...)1 1
‘“1: y$r&mary~~R~R”,“ni do you:
Which best describes vour familv income?
1. q Under$15,000- 7. 0 $100,000-$124,999
2.
q $15,000-$24,999
8.
0 $125,000-$149,999
3. q $25,000-$34,999 9. 0 $150,000-$174,999
4.
q $35,000-$49,999
10. 0 $175,000-$199,999
5.
q $50,000-$74,999 11. q $200,000-$249,999
6. 0 $75,000.$99,999 12.
q
$250,000 or over
Education:
(Pleasecheckwhichcategoryappliestoyou):
1. 0 Somehighschool
3.
0 Collegedegree
2. q Completedhighschool 4. q Graduatedegree
In the last six (6) months has anyone in your household
purchased any of the following items through the mail
and/or over the internet?
AffF B.Internet
1, Books/magazines q
2. Children’sproducts
3.
Clothes Li i
4. Insurance/financialproducts
5. Music/video/DVD : E
6. Travel
7. Other : E
I use these credit cards:
1. q AmericanExpress 4. q Visa
2. q Gas/Retail 5. 0 Other
3. q MasterCard 6. q Donot havecreditcards
Someonein mv home oarticioates in the followina activities:
‘:1”;
2. 0
3.
q
4.
q
5. 0
6.
q
7.
q
8.
q
9. q
10.
q
11.
q
12.
q
13.
q
(all that apply) ’
Automotivework
Bible/devotional
Boating/sailing
Camping/hiking
Casinogambling
Contibutetocharitablecauses
Crafts
Culturalatievents
Cycling
Do-it-yourself
Enter
SweeDStakedCOnteStS
Fishing
Fitness/exercise/iooaina
19. q
20.
q
21.
q
22.
q
23. 0
i 24. 0
25. 0
26. 0
27. 0
28.
q
29. q
30.
q
31.
q
Hunting/Shooting
l+n&mm (m&al funds,IR&s)
Invesbnents(stocks&bonds)
;;;awa;hing
Owna dog
Personalcomputing/ intemet
Photography
Readbooks
Snowskiing
Selfimprovement
Soccer
Tennis
’ I- -14. q Gardening 32. q Travel-Foreign
15. q Golf 33. q Travel-US
16. q Gourmetcooking/food/wines34. q TVshopping
17. q Grandchildren 35. q Vitamins/naturalfoods
18. q Homedecorating 36. q WatchsportsonTV
COMMENTS: 1
A
Thank
youforcompleting
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questlonnalreYouranswerswill
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