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Warranty Demographics Survey Template

Demographic, purchase and product information for warranty survey.


Occupation: (check all that apply)
You
Spouse
Professional/Technical
Upper Management/Executive
Middle Management
Sales/Marketing
Clerical/Service Worker
Tradesman/Machine Operator/Laborer
Product Model: (on tag in product. Example: "LBI###")
Name of store where purchased:
What type of [Brand] product did you purchase?
How would you describe this purchase? (check only one)
What other brands did you consider?
How do you plan to use this product?
Was this product...
How did you first learn about [Brand] products?
Which of the following MOST influence you when purchasing [Brand] products?

Your date of birth: (month and year)
Marital status:
Which group describes your annual family income?
Level of education: (check the highest level completed)
Name
Address
City
State
Zip
Email Address

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