Product Registration: Consumer Product

Consumer product registration, purchase reason, demographics.



   
 
Are you:
 
Male
 
Female
 
   
 
 
   
 
   
 
Did you receive this product as a gift?
 
Yes
 
No
 
   
 
How did you first discover this product was available for purchase?
 
Advertising - TV, newspaper, magazine, radio
 
Ad in another (product) - brochure, preview
 
Friends/Family/Someone told me about it
 
Read a magazine article/review
 
Saw it in the store/Browsing in store
 
Through the mail/mail catalog
 
Other
    
 
   
 
What is the one reason you purchased this (product)?
 
Someone asked for it
 
Makes a great gift
 
Own other (products) and wanted more
 
It is a classic
 
Good for the whole family
 
Saw it in the store
 
I like the (product)
 
Price/Good value
 
Other
    
 
   
 
 
   
 
   
 
 
   
 
   
Primarily, for whom was this product purchased?
Male Female
2 yrs. or younger
3-5 yrs.
6-8 yrs.
9-12 yrs.
13-17 yrs.
18-24 yrs.
25-34 yrs.
35-44 yrs.
45-54 yrs.
55+ yrs.
 
   
 
 
   
 
   
 
 
   
 
   
 
 
   
 
   
 
 
   
 
   
 
Your age:
 
12 yrs. or younger
 
13-17 yrs.
 
18-24 yrs.
 
25-34 yrs.
 
35-44 yrs.
 
45-54 yrs.
 
55-64 yrs.
 
65+ yrs.
 
   
 
 
   
 
   
What are the ages of the children in your household? (Check all that apply)
Boys Girls
Under 6 mos.
6-11 mos.
1 yr.
2 yrs.
3 yrs.
4 yrs.
5 yrs.
6 yrs.
7 yrs.
8 yrs.
13-17 yrs.
11 yrs.
12 yrs.
9 yrs.
10 yrs.
 
   
 
What is your annual household income?
 
Below $20,000
 
$20,000-$29,999
 
$30,000-$39,999
 
$40,000-$49,999
 
$50,000-$74,999
 
$75,000-$99,999
 
$100,000-$149,999
 
$150,000+
 
   
 
 
   
 
   
 
 
   
 
   
 
 
   
 
   
 
 
   
 
   
 
 
   
 
   
 
 
   
 

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