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    Contact information

    First Name:*

    Last Name:*

    Email Address:*

    [te*l phone class:contact-no-filds "Contact No.*"]

     

    Contact No.*

    [te*l phone class:contact-no-filds "Contact No.*"]

    Country:*

    State:*

    City:*

    Zip Code:*

    Purchase information

    Brand :*

     

    Name of the product you purchased :*

     

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    Date purchased :*

     

    Name of store or website where this product was purchased :*

     

    What is the primary reason why you decided to purchase this product? (Please
    select only one)
    :

     

    Other :

     

    Please select all other reasons why you decided to purchase this product.

    (To select more than one, hold down the Ctrl key.)

     

    Other :

     

    How would you rate your overall satisfaction with this product?

     

    What sources, if any, did you use to research this product before you purchased
    it?

    (To select more than one, hold down the Ctrl key.)

     

    Prior to purchasing this Product or doing research to purchase this Product, had
    you heard of Interfoto?

     

    Which of the following do you currently own or plan to purchase in the next 6 months?

    Currently own:

    Plan to purchase in the next 6 months:

    How would you characterize your photography experience?

     

    Which of the following magazines have you read in the past 3 months?

    (To select more than one, hold down the Ctrl key.)

     

    Please type in the names of up to five other magazines that you have read in the
    past 3 months. Please think of all types of magazines, not just those that are related
    to photography or electronics.

     

    Gender :

     

    Age :

     

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