Infinity - Home Audio

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1.

TITLE *

MR.

MRS.

MS.

MISS

FIRST NAME *

INITIAL

LAST NAME *

ADDRESS *

ADDRESS

CITY *

STATE *

POSTAL CODE *

E-MAIL ADDRESS *

COUNTRY *

2.

DATE OF PURCHASE *

MONTH

DAY

YEAR

3.

SERIAL NUMBER *

4.

MODEL NUMBER *

5.

WHERE DID YOU PURCHASE OUR PRODUCT? *

6.

FROM WHAT TYPE OF STORE WAS THIS PRODUCT PURCHASED? *

AUDIO / VIDEO STORE	CAR AUDIO SPECIALTY
ELECTRONICS / APPLIANCE STORE	RECEIVED AS GIFT
MAIL ORDER / INTERNET	DIRECT MAIL
CATALOG	PREMIUM/INCENTIVE
COMPUTER STORE	OTHER

7.

WHICH OF THE FOLLOWING MOST INFLUENCED YOUR DECISION? *

ADVERTISING

PRODUCT PERFORMANCE

BRAND NAME

PRODUCT REVIEW

SALESPERSON RECOMMENDATION

OUR WEB SITE

LENGTH OF WARRANTY

OTHER WEB SITES

PRODUCT DISPLAY

8.

PLEASE INDICATE IF YOU PARTICIPATE IN ANY OF THE FOLLOWING ACTIVITIES.
THEN, PLEASE INDICATE THE NUMBER OF TIMES YOU PARTICIPATE.
(Optional)

	PARTICIPATE IN	# OF TIMES PER MONTH YEAR
THEATER
LIVE CONCERTS
MOVIES
RENT VIDEOS/DVDS
PURCHASE CDS/DVDS

9.

WHICH PUBLICATION(S) DOES ANYONE IN YOUR HOUSEHOLD SUBSCRIBE TO OR READ REGULARLY?
(Optional)

NAME	FROM NEWSTAND	RECEIVE BY MAIL	RECEIVE ON-LINE

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