Occupation: (check all that apply)
Product Model: (on tag in product. Example: "LBI###")
Name of store where purchased:
What type of [Brand] product did you purchase?
How would you describe this purchase? (check only one)
What other brands did you consider?
How do you plan to use this product?
How did you first learn about [Brand] products?
Which of the following MOST influence you when purchasing [Brand] products?
Your date of birth: (month and year)
Which group describes your annual family income?
Level of education: (check the highest level completed)