Product Registration:

By submitting this information, we can confirm the date of purchase for your product. This confirmation is of benefit to you, especially if your original proof of purchase is lost. Registration of your product is not required for warranty activation.

  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.  
  5. Approximately, what price did you pay for this product (excluding tax)?$ .00
    6.  
  6. Model number:
    7.  
  7. Did you:
     
    Purchase this product yourself?
    Receive this product as a gift?
    8.  
  8. Please indicate the name of the store where this riflescope was purchased:


    9.  
  9. What factors most influenced your decision to purchase this riflescope?
    (check all that apply)
     
    Don't know
    Style/Appearance
    Price
    Warranty
    Brand name     		Ease of use
    Product features
    Clarity of view
    Quality
    Other
    10.  
  10. How did you first become aware of this product?
     
    Don't know
    Magazine ad
    Newspaper ad
    Store display
    Consumer magazine article
    Product literature packed in another
           product     		Friend/Relative
    Salesperson
    Association/Society membership
    Previous ownership of our products
    Other
    11.  
  11. What are the primary intended activities for which this riflescope will be used?
    (check all that apply)
     
    Big game hunting
    Target shooting
    Silhouette shooting
    Air rifle shooting     		Varminting
    Plinking
    Small game hunting
    Other
    12.  
  12. What type of gun will this scope be mounted on?
     
    Bolt action
    Auto/Pump rifle
    Lever action rifle
    Handgun     		Single shot rifle
    Shotgun
    Airgun
    13.  
  13. This scope was purchased for:
     
    New Gun
    For a gun you already own
    As part of a rifle and scope combination package
    14.  
  14. If you own any other riflescopes. spotting scopes, telescopes, or binoculars, please indicate the brand you own.
    (check all that apply)
     
    Bushnell
    Simmons
    Leupold
    Redfield
    Tasco     		Bausch & Lomb®
    Burris
    Nikon
    Other
    15.  
  15. What outdoor recreation/sporting magazines do you read regularly (2 out of the last
    4 issues)?

    A.
    B.
    C.
    16.  
  16. Other than the product you just purchased, which of the following products do you intend to purchase in the next year?
    (check all that apply)
     
    Binoculars
    Spotting Scope
    Riflescope
    Night Vision     		Telescope
    Rangefinder
    HOLOsight®
    Speed Gun
    17.  
  17. 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):
    18.  
  18. Occupation: (select all that apply)
     
      You Spouse
    Professional/Technical
    Upper Management/Executive
    Middle Management
    Sales/Marketing
    Clerical/Service Worker
    Tradesman/Machine Operator/Laborer
    19.  
  19. 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?
    20.  
  20. 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
    21.  
  21. Level of education: (Select highest level completed)
     
    Completed High School
    Completed College
    Completed Graduate School
    22.  
  22. Which credit cards do you use regularly?
     
    American Express, Diners Club
    MasterCard, Visa, Discover     		Department Store, Oil Company, etc.
    Do not use credit cards
    23.  
  23. For your primary residence, do you:
     
    Own? Rent?
    24.  
  24. 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
    25.  
  25. 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
    26.  
  26. 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
    27.  
  27. Using the numbers in the above list, please indicate your 3 most important activities:
     
           
    28.  
    To submit this registration, press this button:
    To clear the form, press this button:


    Failure to submit this registration will not diminish your warranty rights.

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