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 Please review the errors below: (Questions with errors are marked with "X")
Required fields are indicated with *
  1. Name & Address:  
     
    Title
       First     Initial     Last 
    Street
       Apt 
    City
       State/Prov     Zip/Postal Code 
    E-mail 
  2. Your date of birth:
  3. Marital status: Married Single
  4. Details for each product purchased:
    Model number:
    (From instruction book)
    Purchased From
    (Name of store, catalog etc.)
  5. Date of purchase: 
  6. Where will this furniture primarily be used?
  7. What two factors most influenced your purchase? (check only 2)
    Magazine ad
    Newspaper/Flyer ad
    Catalog
    Friend's recommendation
    Store display
    Salesperson's recommendation
    Brand name
    Value for the price
    Website
    Television ad
    Other
  8. How satisfied are you with the quality of this product?
  9. How would you rate the overall quality of the assembly instructions?
  10. Please estimate the amount of time it took to assemble this unit.
  11. A. Who was the primary influence in purchasing this item?
    Male Female

    B. Age of person above:
    Under 12 years old
    Age 13-17 yrs.
    Age 18-25 yrs.
    Age 26-49 yrs.
    Age 50+ yrs.
  12. What brands of ready-to-assemble (prefinished unassembled) furniture have you purchased in the past?
    This is my first purchase
    Ameriwood
    Armstrong
    Creative Interiors
    Bush
    HomeTrends
    IKEA
    Mill's Pride/Room Additions
    O'Sullivan
    Sauder
    Studio RTA
    Mainstays
    Z-Line
    Charleswood/Ridgewood
    Do not remember
    Other
  13. Based on your experience with Sauder furniture, would you consider buying another Sauder product in the future?
    Yes No
  14. Are there others living in your household? Yes No  
  15. Occupation/Employment Status: (check all that apply)
      You Spouse   You Spouse
    Professional/Technical Healthcare - Physician/Nurse/Other
    Upper Management/Executive Homemaker
    Middle Management Military
    Sales/Marketing Retired
    Clerical/Service Worker Self Employed/Business Owner
    Tradesman/Machine Op./Laborer Work from Home Office
    Teacher/Educator  
  16. Which group describes your annual family income?
  17. Level of education:
  18. For your primary residence, do you:  Own  Rent
  19. What type of internet access do you use at home?
  20. Please indicate the items that you or someone in your household own.  
    Plasma/LCD TV
    High Def Enabled TV
    Digital Video Recorder
    Game System
    Satellite Radio
    Wireless Internet
    Home Theater
    Wireless Email Device
    GPS
    MP3 Player
    Digital Camera
  21. When new products that have the latest technologies appear on the market,
    do you or someone in your household:

     
    Tend to buy such items as soon as they are available?
    Tend to wait until the item has been around for a while before buying?
  22. 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?
     
    Home Life
    Grandchildren
    Home Improvement/
          Do-It-Yourself
    Gardening
    Own a Dog
    Own a Cat

    Leisure
    Cultural/Art Events
    Avid Book Reading
    Bible/Devotional Reading
    Gourmet Cooking/Fine Foods
    Wines
    Art/Antique Collecting
    Stamp/Coin Collecting
    Crafts
    Sewing/Needlework/Knitting
    Travel
    Airline Club/Frequent Flyer
    Travel in USA
    Foreign Travel
    Cruise Ship Vacations
    RV Vacations
    Casino Gambling

    Investing and Money
    Shopping by Catalog/Mail Order
    Shopping by Internet
    Use Credit Cards Regularly
    Donate to Charitable Causes
    Investments/Money Making       Opportunities
    Contests/Sweepstakes
    Great Outdoors
    Hunting/Shooting
    Fishing
    Camping/Hiking
    Wildlife/Environmental Issues
    Boating/Sailing

    Sports, Fitness & Health
    Physical Fitness/Exercise
    Walking for Health
    Health/Natural Foods
    Dieting/Weight Control
    Self-Improvement
    Golf
    Biking
    Snowboarding/Snow skiing
    NASCAR
    


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