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- Name & Address:
- Your date of birth:
- Marital Status:
Married
Single
- Date of purchase:
- Name
of store/outlet where purchased:
- Model number:
- Price
paid (excluding sales tax): $
.00
- Which
best describes this purchase?
-
If a replacement, which brand did you own previously?
-
What will be the primary use of this shredder?
-
Who were the primary decision makers in purchasing this Fellowes
brand shredder?
-
How did you first become aware of this paper shredder? (check
only one)
-
What factors most influenced your decision
to purchase this paper shredder?
(check up to 3)
-
Check the top 3 features which influenced your decision to buy
this Fellowes paper shredder?
- Where
will you keep your paper shredder?
(check only 1)
-
How often will you use your paper shredder?
(check only 1)
- Not
including yourself, what is the GENDER and AGE (in years)
of children and other adults living in your household?
No one else in household
Child under 1 year
1. Male
Female
Age (in yrs):
2. Male
Female
Age (in yrs):
3. Male
Female
Age (in yrs):
4. Male
Female
Age (in yrs):
- Occupation:
(select all that apply)
- Are
you or your spouse:
- Which
group describes your annual family income?
Under
$15,000
$15,000-$19,999
$20,000-$29,999
$30,000-$39,999
$40,000-$49,999
|
$50,000-$59,999
$60,000-$74,999
$75,000-$99,999
$100,000-$124,999
$125,000-$149,999
|
$150,000-$174,999
$175,000-$199,999
$200,000-$249,999
$250,000
& over |
- Level
of education: (select
highest level completed)
Completed High School
Completed College
Completed Graduate School
- Which
credit cards do you use regularly?
- For
your primary residence, do you:
Own?
Rent?
- Which
of the following do you plan to do within the next 1-6 or 7-12
months? (select all that apply)
- Please
check all that apply to your household.
- To
help us understand our customers’ lifestyles, please indicate
the interests and activities in which you or your
spouse enjoy participating on a regular basis.
- Using
the numbers in the above list, please indicate your 3 most important
activities:
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