Mr.  Mrs.  Ms.  Mss 
* Name / Nom
MI
* Last Name / Prenom

Address (Number and Street)/Adresse
Apartment #

City/Ville
State/Province
Zip Code

Phone Number

* Email


About the Unit
* Purchase Price:
$
* Date of Purchase (MM/DD/YY):
* Model Number:
* Serial Number: (Numbers Only)

Store Location:


A Little About You
What factors most influenced this purchase? (check up to 3)
Received as a Gift
Style/Appearance
Brand Reputation
Price
Technical Application
Recommended by Friend/Relative
Recommended by Salesperson
Product Features
Previously owned pressure washer
Advertising
Ease of Operation
Power of Product
Size/Weight
Portability


What activities do you participate in regularly?
Camping
Fishing
Hunting/Shooting
Boating/Sailing
Recreational Vehicle
Automotive Work
Automotive Repair
Home Improvement
CB Radio
4-Wheel Drive
Motorcycling


What other brands did you consider before buying this product?
Air Tool Company
Campbell Hausfeld
Devilbiss
Excell
Porter Cable
Honda
Karcher
Coleman
Simoniz
Powerwasher
Black & Decker
Ryobi
Husky
Sistema
Sears/Craftsman
None
Other


Which of the following best describe this purchase?
(check all that apply)
First Purchase
Replacement: specify brand
Addition to: specify brand


What other outdoor equipment do you own?
Lawn mower
Gas Trimmer
Chain saw
Leaf Blower
Compressor
Generator
Gas pressure washer
Electric pressure


What are the primary cleaning uses for your pressure washer?
Driveways
Walkways
Siding/Gutters
Fences
Auto/Trucks
Outdoor lawn tools
Decks
Playsets


Would you like to receive e-mail remiders or updates?
Yes No


Which best describes you?


Marital Status
Single Married


Which best describes your family income?
Under $15,000
$50,000-$74,999
$15,000-$24,999
$25,000-$34,999
$35,000-$49,999
$75,000-$99,999
$100,000-$149,999
Over $150,000

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