Product Registration


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  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. Price paid (excluding sales tax): $ .00
    6.  
  6. Name of store where purchased:
    7.  
  7. Model number:
    8.  
  8. Registration number:

    9.  
  9. Who installed your door?
    Builder
    Remodeler
    Self-installation    		 Contractor
    Other
    10.  
  10. How did you learn about Larson?
    In-Store Display
    Newspaper Ad
    Magazine Ad
    TV Commercial
    Larson Brochure    		 Previous Purchase
    Salesperson
    Friend/Referral
    Website
    11.  
  11. Age of your home?
    1-4 years
    5-10 years    		 11-25 years
    More than 25 years
    12.  
  12. How long have you lived in your current residence?
    0-2 years
    3-5 years
    6-10 years    		 11-15 years
    Over 15 years
    13.  
  13. Please indicate the factors that most influenced your selection.
    Style/Appearance
    Weather Protection
    Value for Price
    Security
    Warranty
    Product in Stock
    Craftsmanship
    Energy Efficiency
    14.  
  14. Please indicate the features that most influenced your selection.
    Interior Handle
    Exterior Handle
    Color Options
    Thickness of Door
    Keyed Lock
    15.  
  15. Please check all that apply to your household.
    Own a Compact Disc Player
    Subscribe to an Online/Internet Service
    Own an IBM or Compatible Computer     		Own an Apple/Macintosh Computer
    Own a CD-ROM
    16.  
  16. 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
    17.  
  17. 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
    18.  
  18. 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):
    19.  
  19. Which credit cards do you use regularly?
    American Express, Diners Club
    MasterCard, Visa, Discover    		 Department Store, Oil Company, etc.
    Do not use credit cards
    20.  
  20. 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. Gardening
    02. Hunting/Shooting
    03. Bible/Devotional Reading
    04. Travel in USA
    05. Cruise Ship Vacations
    06. Photography
    07. Avid Book Reading
    08. Foreign Travel
    09. Home Workshop/Do-It-Yourself
    10. Our Nation’s Heritage
    11. Golf
    12. Wildlife/Environmental Issues     		13. Fishing
    14. Physical Fitness/Exercise
    15. Entering Sweepstakes
    16. Casino Gambling
    17. Dieting/Weight Control
    18. Wines
    19. Gourmet Cooking/Fine Foods
    20. Bicycling
    21. Health/Natural Foods
    22. Self-Improvement
    23. Stocks/Bonds/Mutual Funds
    24. Watching Sports on TV
    21.  
  21. Using the numbers in the above list, please indicate your 3 most important activities:
           
    22.  

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We believe you should know:

1. What information this site gathers about you

2. What this site does with the information it tracks

3. With whom this site shares the information it gathers

We collect personal information about our users only during product registration. We do not use cookie technology to track your movements.

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, and to send you coupons, or notify you of products and services of our affiliates that relate directly to your specific interests, hobbies or other information you have given.

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All data is stored in a highly secure database with state of the art backup and firewall technologies. It is not accessible to any unauthorized parties. This means that your information is kept safe, and is only disclosed to selected third parties to provide you with valuable information and special offers.

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