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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. YES! I want to receive offers or communications from Wagner via e-mail.
     
  2. Telephone Number: ( ) -
    3.  
  3. Your date of birth:
    4.  
  4. Marital Status: Married Single
    5.  
  5. Date of purchase: 
    6.  
  6. Model number:
    7.  
  7. Purchase price: $ .00
    8.  
  8. Store name:
    9.  
  9. How did you first learn of the Wagner product you purchased?
     
    TV commercial
    Magazine ad
    Store Display
    Friend/Relative recommendation
    Mailing to your home    		 Newspaper ad/circular
    Salesperson's recommendation
    Previous experience with Wagner
    Other
    10.  
  10. What are the top (3) factors causing you to make this purchase? (check up to three)
     
    Performance
    Value for the price
    Advertising
    Item on sale
    Previous experience
    Packaging
    Warranty    		 Style/appearance
    Recommendation
    In-store display
    Quality
    Brand
    Features
    Other
    11.  
  11. Approximate number of stores you shopped:
     
    One
    Two
    Three
    Four+
    12.  
  12. Approximately how long did you spend shopping for this purchase?
     
    Impulse
    One day
    2-3 days    		 4-6 days
    One week
    Several weeks
    13.  
  13. What types of stores did you shop at for this product?
     
    Received as a gift
    Hardware store
    Home center
    Building supply
    Warehouse club    		 Discount store
    Specialty paint store
    Department store
    Mail order
    Other
    14.  
  14. Please check which products you own and which you have a need for:
     
      Have Need
    Power paint sprayer
    Power paint roller
    FineCoat (HVLP) paint sprayer
    Wallpaper steamer
    15.  
  15. What level of Do-It-Yourself activities do you engage in?
     
    A. Lighter Activities
     
    Tightening screws
    Interior painting

    B. Medium Activities
     
    Wallpapering
    Exterior painting
    Building shelves
    Hanging window coverings

    C. Heavy Activities
     
    Remodeling
    Deck building
    Additions

    D. Woodworking
     
    Build cabinets
    Build furniture
    Wood refinishing

    E. Professional Activities
     
    Earn income doing any of the above

    16.  
  16. What is the primary intended use of this product?
     
    Removing paint
    Shrink tubing or shrink wrap
    Thawing frozen pipes and locks    		 Hobbies and crafts
    Removing floor tiles
    Other
    17.  
  17. On how many projects do you intend to use this product within the next 12 months?
     
    One
    Two
    Three
    Four+
    18.  
  18. Other products considered?
     
    Manual scraper
    Torch
    Power scraper
    Drill accessory (scraper wheel)    		 A different model Wagner heat tool
    A Milwaukee heat tool
    Other
    19.  
  19. How old is your home?
     
    0-5 years
    6-10 years
    11-15 years    		 16-25 years
    26-35 years
    Over 35 years
    20.  
  20. How many years have you lived in your home?
     
    0-6 months
    6 months-1 year
    1-2 years    		 3-5 years
    Over 5 years
    21.  
  21. 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):
    22.  
  22. Occupation: (check all that apply)
     
      You Spouse
    Professional/Technical
    Upper Management/Executive
    Middle Management
    Sales/Marketing
    Clerical/Service Worker
    Tradesman/Machine Operator/Laborer
    23.  
  23. 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 Veteran?
    24.  
  24. 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
    25.  
  25. Level of education: (select highest level completed)
     
    Completed High School
    Completed College
    Completed Graduate School
    26.  
  26. Which credit cards do you use regularly?
     
    American Express, Diners Club
    MasterCard, Visa, Discover     		Department Store, Oil Company, etc.
    Do not use credit cards
    27.  
  27. For your primary residence, do you:
     
    Own? Rent?
    28.  
  28. How recently did you move into your current residence?
     
    Within 30 days
    Within 1-3 months
    Within 4-6 months     		7 to 12 months ago
    Have not moved in the last 12 months
    29.  
  29. 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
    Buy/Lease a New Vehicle
    Buy/Lease a Used Vehicle
    30.  
  30. Please tell us about the newest car or truck in your household.
     
    Make of vehicle: Bought new
    Model name: Bought used
    Year: Lease
       Leased used
    31.  
  31. Please check all that apply to your household.
     
    Shop by Catalog/Mail
    Shop via the Internet
    Member of Frequent Flyer Program
    Donate to Charitable Causes
    Own a Compact Disc Player
    Have a Dog     		Have a Cat
    Own a Wireless/Cellular Phone
    Speak Spanish
    Own an Apple/Macintosh Computer
    Own a CD-ROM Drive
    32.  
  32. 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. Powerboating
    11. Sailing
    12. Grandchildren
    13. Needlework/Knitting
    14. 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 (RVs)
    23. Listen to Records/Tapes/CDs
    24. Avid Book Reading
    25. Bible/Devotional Reading
    26. Health/Natural Foods
    27. Photography     		28. Cultural/Arts Events
    29. Fashion Clothing
    30. Art/Antique Collecting
    31. Foreign Travel
    32. Cruise Ship Vacations
    33. Travel in USA
    34. Gourmet Cooking/Fine Foods
    35. Wines
    36. Stamp/Coin Collecting
    37. Collectibles
    38. Our Nation’s Heritage
    39. Real Estate Investments
    40. Stocks/Bond Investments
    41. Contests/Sweepstakes
    42. Casino Gambling
    43. Science Fiction
    44. Wildlife/Environmental Issues
    45. Dieting/Weight Control
    46. Science/New Technology
    47. Self-Improvement
    48. Walking for Health
    49. Watching Sports on TV
    50. Home Video Recording
    51. Moneymaking Opportunities
    33.  
  33. Using the numbers in the above list, please indicate your 3 most important activities:
     
           




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