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  1. Name & Address:  
     
    * Title Mr.    Mrs.    Ms.    Miss
    * First Name Initial * Last Name
           
    * Street Apt. No. * City
    * State/Province * Zip/Postal Code
    * E-mail Address
    2.  
  2. Your date of birth:
    3.  
  3. Marital Status: Married Single
    4.  
  4. Date of purchase: 


  5. Model Number:

  6. Did you:
    Purchase this product yourself?
    Receive this product as a gift?


  7. Name of store where purchased:

  8. Was this product on sale when you purchased it?
    Yes
    No


  9. Did you decide to buy a clock/radio
    Before you entered the store?
    While you were in the store?


  10. Is this the first Timex product you have ever owned?
    Yes
    No


  11. Price paid: (excluding sales tax) $ .00

  12. Which of the following best describes this purchase?
    The first product of this type you've owned
    A replacement/upgrade of a similar product
    An addition to a similar product you already own
    Other


  13. Please indicate the age & gender of the person who will be using this product most often:
    Male
    Female
        Age: years

  14. What other brands did you seriously consider before making this purchase?
    No other brands considered
    Emerson
    GE
    RCA
    Magnavox/Philips
    Panasonic
    Oregon Scientific
    		 Sony
    Westclox
    Advance
    Jensen
    Aiwa
    Other


  15. What factors most influenced this purchase? (check up to 3)
    Brand reputation
    Friend's/Relative's recommendation
    Magazine ad
    Magazine article/Review
    Newspaper ad
    Previous experience with the brand
    Price    		 Salesperson's recommendation
    Special offer included with the product
    Specific product features
    Store display
    Internet website
    Overall design
    Other


  16. What features most influenced this purchase? (check up to 3)

    Battery backup
    Color
    Memory
    Quality/Durability
    Shape/Size/Design
    Sleep timer
    Wake to radio/alarm
    Brightness control
    Cassette player
    CD player
    Day/Date calendar
    Dual alarms
    Message Mate

    		 Instant weather
    Remote control
    Nature sounds
    Sound therapy
    Sound quality
    Digital tuning
    Jumbo clock display
    Aromatherapy
    E-Z set
    Auto-set
    Redi-set
    Other


  17. Which of the following products do you plan to purchase in the next 6 months? (check all that apply)
    Audio rack system
    Audio rack/video system
    Boombox w/cassette
    Boombox w/CD player
    Boombox w/multi-CD player
    Camcorder
    Car stereo
    Cellular phone
    Clock radio/CD player
    Clock radio/Phone
    Compact stereo system
    Component stereo system
    Corded phone    		 Cordless phone
    Electronic keyboard
    Electronic organizer
    Clock
    Home safety electronics
    Kitchen appliances
    Portable cassette player
    Portable CD player
    Personal computer
    Speakers
    MP3
    Shower radio


  18. 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):


  19. Occupation: (select all that apply)
      You Spouse
    Professional/Technical
    Upper Management/Executive
    Middle Management
    Sales/Marketing
    Clerical/Service Worker
    Tradesman/Machine Operator/Laborer


  20. Are you or your spouse:
      You Spouse
    A Homemaker?
    Retired?
    A Student?
    Self Employed/Business Owner?
    Working from a Home Office?
    In the Military?
    A Federal Employee?


  21. 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


  22. Level of education: (Select highest level completed)
    Completed High School
    Completed College
    Completed Graduate School


  23. Which credit cards do you use regularly?
    American Express, Diners Club
    MasterCard, Visa, Discover    		 Department Store, Oil Company, etc.
    Do not use credit cards


  24. For your primary residence, do you: Own?     Rent?
  25. Which of the following do you plan to do within the next 1-6 or 7-12 months? (select all that apply)

      1-6 Months 7-12 Months
    Get Married
    Have a Baby
    Buy a House
    Remodel a Home
    Move to a New Residence
    Buy a Personal Computer
    Buy/Lease a New Vehicle
    Buy/Lease a Used Vehicle


  26. Please check all that apply to your household.
    Shop by Catalog/Mail
    Member of Frequent Flyer Program
    Donate to Charitable Causes
    Own a Compact Disc Player
    Have a Dog
    Have a Cat
    		Own a Cellular Phone
    Subscribe to an Online/Internet Service
    Own an IBM or Compatible Computer
    Own an Apple/Macintosh Computer
    Own a CD-ROM


  27. 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.
    01. Bicycling
    02. Golf
    03. Physical Fitness/
               Exercise
    04. Running/Jogging
    05. Snow Skiing
    06. Tennis
    07. Camping/Hiking
    08. Fishing
    09. Hunting/Shooting
    10. Horseback Riding
    11. Powerboating
    12. Sailing
    13. Grandchildren
    14. Needlework/Knitting/
               Sewing
    15. Flower Gardening
    16. Vegetable Gardening
    17. Crafts
    18. Buy Prerecorded
               Videos     		19. Automotive Work
    20. Electronics
    21. Home Workshop/
               Do-It-Yourself
    22. Recreation Vehicles
    23. Listen to Records/
               Tapes/CDs
    24. Surf the Internet
    25. Avid Book Reading
    26. Bible/
               Devotional Reading
    27. Health/Natural Foods
    28. Photography
    29. Attending Cultural/
               Arts Events
    30. Fashion Clothing
    31. Fine Art/Antiques
    32. Foreign Travel
    33. Cruise Ship Vacations
    34. Travel in USA
    35. Gourmet Cooking/
               Fine Foods
    		36. Wines
    37. Coin/Stamp Collecting
    38. Collectibles/Collections
    39. Our Nation’s Heritage
    40. Real Estate Investments
    41. Stocks/Bonds/
               Mutual Funds
    42. Entering Sweepstakes
    43. Casino Gambling
    44. Science Fiction
    45. Wildlife/
               Environmental Issues
    46. Dieting/Weight Control
    47. Science/New Technology
    48. Self-Improvement
    49. Walking for Health
    50. Watching Sports on TV
    51. Home Video Recording
    52. Moneymaking
               Opportunities


  28. Using the numbers in the above list, please indicate your 3 most important activities:
            



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