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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.
     
  3. Telephone Number: ( ) -
  4.  
  5. Your date of birth:
  6.  
  7. Marital Status: Married Single
  8.  
  9. Date of purchase: 
  10.  
  11. Name of store where purchased:
  12.  
  13. Price paid (excluding sales tax): $ .00
  14.  
  15. Which category of Paint Sprayer did you purchase?
     
    1300psi
    1500psi
    1600psi
    1700psi
    1800psi
    2000psi
    2200psi
    2400psi
    2600psi
    Paint Crew
    Other
  16.  
  17. How did you first learn of the Wagner product you just purchased?
     
    TV commercial
    Magazine advertisement
    Store display
    Friend's/Relative's recommendation
    Salesperson's recommendation
    Mailing to your home
    Newpaper advertisement/circular
    Previous experience with Wagner
    Other
  18.  
  19. What are the top (3) factors causing you to make this decision? (select only three)
     
    Performance
    Value for the price
    Advertising
    Item on sale
    Previous experience
    Packaging
    Warranty
    Style/appearance
    Recommendation
    In-store display
    Quality
    Brand
    Feature
    Other
  20.  
  21. What is the most important benefit you believe this product will provide?
     
    Make painting easier
    Paint with less mess
    Make clean-up faster
    Versatility for many jobs
    Allows me to Do-It-Myself
    Make job faster
    Paint with better control
    Provide a professional result
    Use less paint/save money
    Other
  22.  
  23. Approximate number of stores you shopped:
     
    One
    Two
    Three
    Four+
  24.  
  25. What type of store did you shop at for this product?
     
    Received as a gift
    Hardware store
    Home center
    Building supply
    Warehouse club
    Discount store
    Specialty paint store
    Mail order
    Other
  26.  
  27. Approximately how long did you spend shopping for this purchase?
     
    Impulse
    One day
    2-3 days
    4-6 days
    One week
    Several weeks
  28.  
  29. Check which applies:
     
      Wagner Products Owned Have a Need For
    Power Painter
    Piston Pump
    Power roller
    HVLP
    Heat Gun
    Steamer
  30.  
  31. Which of the following 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
    Wood Refinishing

    D. Professional Activities
     
    Earn income doing any of the above

  32.  
  33. What is the primary intended use of this product?
     
    Exterior walls
    Interior walls
    Fence/deck
    Shutters/doors
    Wicker/lattice
    Small buildings
    Hobbies/crafts
    Other
  34.  
  35. What is the primary exterior surface of your home?
     
    Wood
    Brick
    Aluminum
    Concrete
    Stucco
    Vinyl
    Steel
    Other
  36.  
  37. What is the primary type of material you intend to spray?
     
    Latex paint
    Latex satin
    Oil-based paint
    Oil-based satin
    Water sealer
    Varnish
    Polyurethane
    Lacquer
  38.  
  39. What is the age of your home?
     
    0-5 years
    6-10 years
    11-15 years
    16-25 years
    26-35 years
    Over 35 years
  40.  
  41. 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):
  42.  
  43. Occupation: (check all that apply)
     
      You Spouse
    Professional/Technical
    Upper Management/Executive
    Middle Management
    Sales/Marketing
    Clerical/Service Worker
    Tradesman/Machine Operator/Laborer
  44.  
  45. 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?
  46.  
  47. 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
  48.  
  49. Level of education: (select highest level completed)
     
    Completed High School
    Completed College
    Completed Graduate School
  50.  
  51. Which credit cards do you use regularly?
     
    American Express, Diners Club
    MasterCard, Visa, Discover
    Department Store, Oil Company, etc.
    Do not use credit cards
  52.  
  53. For your primary residence, do you:
     
    Own? Rent?
  54.  
  55. 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
  56.  
  57. 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
  58.  
  59. 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
  60.  
  61. 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
  62.  
  63. Using the numbers in the above list, please indicate your 3 most important activities:
     
           
  64.  
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