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GREEN STAR
®
ELITE
REGISTRATION FORM
put glue here to seal
PLEASE FILL OUT AND RETURN WITHIN THE NEXT IO DAYS
Please write all information legibly!
1. Customer Information
c
Mr.
c
Mrs.
c
Ms.
c
Miss
First Name
Initial
Last Name
Street
Apt. No
City
State
Zip
Phone
Email Address
2. Date of Purchase: Month
Day
Year
3. Product Information:
Green Star Elite Model #:
Serial #:
4. Dealer Information
Dealer Name
Dealer Address
Phone
• How did you learn of Green Star? (Please check only one.)
c
Received as a gift
c
Magazine advertisement
c
Newspaper advertisement
c
TV advertisement
c
Radio advertisement
c
In-store display or demo
c
Consumer magazine article
c
Friend’s recommendation
c
Salesperson
c
Information through the mail
c
Other
• What is your primary residence?
c
Own a House
c
Own a Townhouse or Condo
c
Rent a House
c
Rent an Apartment, Townhouse or Condominium
• What is your Annual Household Income?
c
Less than $15,000
c
$15,000-$25,000
c
$25,000-$50,000
c
$50,000-$75,000
c
$75,000-$100,000
c
more than $100,000
• What factors most influenced your decision to purchase this juicer? (please check up to three)
c
Green Star reputation
c
Style and appearance
c
Value for the price
c
Special product features
c
Warranty
c
Rebate or sale price
c
Quality and durability
c
Consumer Magazine Article
c
Reputation of the Dealer
c
Friend Recommendation
c
Salesperson
c
Other
• What is your occupation?
c
Homemaker
c
Professional/Technical
c
Upper Management or Executive
c
Middle Management
c
Sales/Marketing
c
Clerical or Service Worker
c
Self Employed/Business Owner
c
Student
c
Retired
c
Tradesman/Machine Operator/Laborer
• Which credit cards do you use regularly?
c
Visa
c
MasterCard
c
American Express
c
Discover
c
Department Store
c
Diner’s Club
c
Gasoline Company, etc.
c
Do not use credit cards
OPTIONAL SURVEY
Содержание GSE-5000
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