Will Burt Night Scan Chief Installation, Operation & Maintenance Manual page 64

Transportable lighting system

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WILL-BURT PRODUCT REGISTRATION

AND EVALUATION

RETURN WITHIN 90 DAYS FROM DATE OF PURCHASE

PLEASE COMPLETE THIS FORM AND RETURN TO WILL-BURT USING THE PREPAID SELF-

ADDRESSED ENVELOPE WHICH HAS BEEN PROVIDED. THANK YOU FOR YOUR

ASSISTANCE.

CUSTOMER NAME: _____________________________________DATE: _______________

ADDRESS:

__________________________________________________________________________

CITY / STATE / ZIP: ________________________PHONE No. : _______________________

PRODUCT MODEL No. / NAME / DESCRIPTION:

___________________________________________________________________________

PRODUCT SERIAL No. : ________________DATE OF PURCHASE: ___________________

DEALER NAME (WHERE PURCHASED):

_________________________________________________________________________

INSTALLER NAME:

_________________________________________________________________________

WHERE DID YOU HEAR ABOUT THIS PRODUCT?

_________________________________________________________________

WHY DID YOU PURCHASE THIS PRODUCT?

______________________________________________________________________

WAS THE PRICE OF THIS PRODUCT COMPETITIVE? YES __________ NO __________

WOULD YOU PURCHASE THIS PRODUCT AGAIN? YES __________ NO__________

WOULD YOU RECOMMEND THE PURCHASE OF THIS PRODUCT TO YOUR FRIENDS OR

THEIR ASSOCIATES? YES __________ NO__________

DOES THE PRODUCT SATISFY YOUR NEEDS / REQUIREMENTS? IF NO, EXPLAIN:

_____________________________________________________________________________

DO YOU BELIEVE ANY FEATURE COULD BE IMPROVED TO ENHANCE THE

PERFORMANCE OF THE PRODUCT? IF YES, EXPLAIN:

_____________________________________________________________________________

PLEASE CONTINUE ON REVERSE SIDE.

FORM No. ENG- 330 - 95 – 03

7/7/00

A 4

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