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ALTEC
~@
LANSING®
IMPORTANT!
IMPORTANT!
Please complete and return within the next 10 days
or register online at www.prodregisler.com/alleclansing
1.1.0
Mr.
First Name
2.0 Mrs.
3. ':J Ms.
4. 0 Miss
Inilial
last Name
XMA01-01
Slreet
Apt. No.
City
State
ZIP Code
E-mail
(please see lower lelt or upper right corner of product front panel)
6.
Name 01 store where purchased:
5.
U
Plane
6.
0
Train
7. 0
Other
Living room
Office
Ree or family room
Olher
5. D
6. D
7. D
8.0
11.
Where do you plan to use this product? (check a/l that appty)
A) Indoors:
1. 0
Bedroom
2. 0
Children's bedroom
3.
0
Gym
4.
D
Kitchen
B) Outdoors:
1.
0
Automobile
2.
D
Bicycling
3.
[J
Camping/picnic
4.
0
Jogging
12.
Not /ncluding youlSe/t, what is the GENDER and AGE (in years)
of children and other adulls living in your household?
1.
D
No one else in household
2.
0
Child under 1 year
2. 0
Single
Year
2.
Your date 01 birth:
/
Month
3.
Marital status: 1.
0
Married
4.
Dale 01 purchase:
/
/
Month
Day
Year
5.
Model number:
Male Female
Age
Male Female
Age
18.
For your primary residence, do you:
1.
0
Own?
2.
0
Rent?
19.
How recently did you move into your current residence?
1.
0
Within 30 days
4.
0
7 to 12 months ago
2. 0
Wilhin 1 - 3 months
5.
0
Have not moved in
3.
D
Within 4 - 6 months
the last 12 months
1.
0
2.
[l
yrs.
1.
0
2.
0
yrs.
13.
Occupation: (check all/hat apply)
You
Spouse
Professional/Technical .....
[J
1.
0
Upper ManagemenUExecutive ..
[]
2.
[J
Middle Management ..
0
3
0
Sales/Marketing ..
D
4.
0
ClericaVService Worker ...
0
5.
0
TradesmanlMachine Operator/laborer ..
0
6.
0
14.
Are you or your spouse:
You
Spouse
A Homemaker? ....
0
1.
0
Retired?.
0
2.
0
A Student? ..
0
3.
D
Sell Employed/Business Owner? ..
D
4.
0
Working lrom a Home Office? ..
D
5.
0
In Ihe Military? ..
C
6.
0
A Veteran?.
C
7.
D
15.
Which group describes your annuallamily income?
01
0
Under $15,000
08
0
$75,000-$99,999
02.
[J
$15,000-$19,999
09. 0
$100,000-$124,999
03
0
$20,000-$29,999
10.
[J
$125,000-$149,999
04
0
$30,000-$39,999
11. 0
$150,000-$174,999
05.
0
$40,000-$49,999
12. 0
$175,000-$199,999
06.
D
550,000-$59,999
13. 0
$200,000-5249,999
07.
r
$60,000-$74,999
14. l
$250,000
&
over
16.
level
01
education: (check highest tevel completed)
1. [" Completed High School
2.
0
Completed College
3.
D
Completed Graduate School
17.
Which credit cards do you use regularly?
1.
0
American Express, Diners Club
2.
C
MasterCard, Visa, Discover
3.
C
Department Siore, Oil Company, etc.
4.
L
Do not use credit cards
yrs.
7-12
Months
o
o
1.
2
1-6
Months
o
[J
yrs.
1.0 2.
D
Buy/lease a New Vehicle ..
Buy/lease a Used Vehicle ..
1.
0
2.0
20.
Which 01 the lollowing do you plan 10 do within the next
6
or 12 months?
9.
What other brands did you seriously consider belore making
this purchase? (check alt Ihat apply)
01.
r]
No other brand
11.
C
Klipsch
considered
12.
,-
Koss
02.
rl
Belkin
13.
C
lablec
03.
Bose
14.
C
logilech
04.
0 Creative
15. 0
Maxell
05.
0
Cyber Acoustics
16
[J
Philips
06.
[J
Dell
17.
0
Plantronics
07.
0
HarmanlKardon
18.
0
Shure
08
l
Jabra
19. 0
Sony
09.
I
JBl
20.
0
Other
10.
.J
Kensington
7.
Did you:
1. 0
Purchase this product yourself?
2. []
Receive this product as a gift?
3. [] Receive this product as a requested gift?
8.
What most influenced your decision to purchase
this product? (check a/l thaI apply)
A) Factors
1.
G
Received as a gift
2. C
Advertisemenl
3.
U
Brand name
4. [] Friend'sIRelative's recommendation
5.
LJ
Packaging
6.
0
Price
7.
[J
Producl brochure
8. 0
Review in magazines
9. 0
Salesperson"s recommendation
10.
0
Store display
B) Features
1.
0
Color design and style
2.
D
Power
3
:J
Size
4.
,J
Sound quality
10.
With what do you plan to use this product? (check up
10 three)
01.
0
Boom box
t 2.
C
Portable cassette
02.
0
CD player
player
03.
0
Portabie CD player
13. [] Portable FM/AM
04.
0
Ceil phone
radio
05.
0
Clock radio
14.
0
Portable MP3
06.
0
Desktop computer
player
07.
lJ
DVD player
15. [] iPod
08.
:-J
Portable DVD player
16.
C
Satellite radio
09. ;:] Home theatre system
17. 0
Stereo rack system
10.
LJ
Micro desktop
18.
D TV
audio system
11. [l Notebook/laptop
computer
PlEASE CONTINUE ON BACK
~ ~ ~
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