| 4 |
Date of
Purchase:
/
/
(example: January/18/2000) |
| 5 |
Serial
number:
|
| 6 |
Store
Name, City, State:
, ,
|
| 7 |
Purchase Price:
$ .00
|
| 8 |
Where do you
hunt? |
| |
|
| 9 |
Send me
information about:
|
| 10 |
What are the
outdoor interests in your household?
|
| 11 |
A. This Remington® just purchased will
be used for:
(Check all that
apply)
|
| |
B. This
Remington® just purchased will be primarily used for:
|
| 12 |
How many
other Remington® Firearms do you own?
|
| 13 |
Which do you use the Internet
for?
(Check all that apply)
|
| 14 |
Your
gender:
|
| 15 |
Your marital
status:
|
| 16 |
Date of Your
birth:
/ /
month
/ day / year
(example: January/18/1969)
|
| 17 |
Including yourself, what is the total number of people living in your
household? (Examples: 01,02,03...)
Children (18 and younger): Adults:
|
| 18 |
Date of birth
(month/year) of children in your household 18 year of age and
younger:
|
| 19 |
For your
primary residence, do you:
|
| 20 |
Education:
|
| 21 |
Which best
describes your family income?
|
| 22
|
|
| 23
|
|
| 24
|
|
| Thanks
for filling out this questionnaire. Your answers are important
to us.
| |
