- Name & Address:
- Your date of birth:
- Marital Status:
Married
Single
- Telephone Number: (
)
-
- Model number:
- Serial number: (located on opener, near light socket)
- Where did you purchase this opener? (Dealer or Retailer Name)
- Did you:
- Was this purchase part of a new home purchase?
- Is this product:
- What factors most influenced your decision to purchase this product? (check up
to three)
- Was this product installed by:
- Size of your garage where the product was installed?
- Number of doors in garage with openers:
- Not including yourself,
what is the GENDER and AGE (in
years) of children
and other adults living in your household?
- Occupation: (check
all that apply)
- Are you or your spouse:
- 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 |
- Level of education: (select
highest level completed)
- Which credit cards do
you use regularly?
- For your primary residence,
do you:
-
How recently did you move into your current residence?
- Which of the following
do you plan to do within the next 1-6 or 7-12 months?
(select all that apply)
- Please check all that
apply to your household.
- 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.
- Using the numbers in
the above list, please indicate your 3 most important activities:
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We respect your right to privacy. As part of the entry process, we give you the opportunity to decline to receive any communications from
other parties to whom we may provide such information.
The data we collect is used in the aggregate to give us demographic information about the entire audience registering their products. We
use this to understand that audience and to improve our offerings to you, our customers.
The personal information you provide - name, address, etc. - allows us to inform you of additional special offers which may be forthcoming,
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