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Consumer Product Registration Survey Template

Consumer [PRODUCT] registration, demographics and purchase reason.


Are you:
Did you receive this [PRODUCT] as a gift?
How did you first discover this [PRODUCT] that was available for purchase?
What is the one reason you purchased this [PRODUCT]?
 
 
How many total [COMPANY NAME] [PRODUCT]s do you own?
How many total [PRODUCT]s of any brand do you own?
How many total [COMPANY NAME] [PRODUCT]s have you purchased in the past 12 months?
How many total [PRODUCT]s of any brand have you purchased in the past 12 months?
Your age:
How many children under 17 yrs. or younger live in your household?
What are the ages of the children in your household? (Check all that apply)
Boys
Girls
Under 6 mos.
6-11 mos.
1 yr.
2 yrs.
3 yrs.
4 yrs.
5 yrs.
6 yrs.
7 yrs.
8 yrs.
Boys
Girls
13-17 yrs.

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