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1
Mr. Mrs. Ms. Miss
First Name:
 		Initial:
 		Last Name:
Address: (Number and Street)
 		Apt #:
City:
 State/Province:
Country:
 		Zip:

Phone Number: () - -

Email Address:
 
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2

Item Number:

Serial Number:

(located on bottom of product)

UPC #:upcbar.gif 2.53 K
(last 6 digits of UPC bar code located on product carton)
 

43765 - *
 3
Date of Purchase: / /
(example: January/18/2001)

Place of Purchase:
(example: Walgreens, Vornado Website)

Purchase Price:
$ .00
 
4 When you first noticed the product, what first caught your attention ?

Size
Weight
Ease of Use
Special Features
Performance
Style/Appearance/Design
Warranty
Other


 

 5 Which three (3) of the following influenced your purchase decision:

Received as a Gift
Price/Value
Prior Vornado Experience
Store Display
Saw Product in Use/Demo
Vornado Reputation
Quality/Dependability
Recommended by Salesperson
Recommended by Friend/Relative
Other

 
6 If you purchased a Vornado AQS air purifier, was it recommended by your doctor?
 
Yes
No
7

What room will this product be used in?

       
8 Would you recommend Vornado products to others?
 

Yes    No

 		 9 I also own the following Vornado Products:
(check each product you own)
       
Circulator
Fan
Air Purifier		 Heater
Humidifier
 
 
10 Education:

11 Which best describes your family income?

 
12 Gender:

Male     Female

Your marital status:
 Married Single

13 For your primary residence, do you:

Own Rent
 
14 Year of your birth:

 
(example: 1969)

15 Including yourself, what is the total number of people living in your household?

(Examples: 01,02,03...)

 
Other Comments
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