Laneventure: Product Registration

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Register Your Product

We at Laneventure thank you for purchasing our furniture. Your retailer can assist in many areas. We would, however, like to know more about you. Therefore, we ask you to complete the following questionnaire.

First Name:	*
Last Name:	*
Address:

City:
State:
Zip:
Phone:
Email:	*
Occupation:
Purchased by:	Male Female Joint Purchase N/A
Age:
Marital Status:
Income:
On a scale of 1 to 7 with 1 being "I strongly agree" and 7 being "I strongly disagree", please rate your agreement with the following:
A. I care more about how my home looks then most people.
B. It's important to me that my whole house be a place where kids can be kids.
C. I'm still trying to make my home the home I've always wanted.
D. I'll never be satisfied with how the inside of my home looks.
E. Impractical furniture is ok as long as it is especially attractive.
F. If furniture cannot stand up to some use and abuse, it doesn't belong in my house.
G. When I buy furniture, I am thinking about how it will look to visitors and guests.
H. I think a home is more appealing when it has a mixture of styles.
I. Shopping for furniture and accessories is a way for me to be creative.
J. I find shopping for furniture intimidating.
K. I don't have the time or interest to worry about decorating.
L. Friends sometimes ask my advice or opinion about home furnishings and decoration.
M. We often have cookouts at our home.
N. I consider myself a compassionate person.
O. Being organized and punctual is an important part of character.

Retailer Name:
City and State:
Date of Purchase:
How did you become acquainted with Laneventure?	Newspaper/Magazine ad Store Display TV/Radio ad Internet Friend/Relative Other
What were the most important features that prompted you to purchase this Laneventure product?
What improvements could be made to this product?
What was the main reason for this furniture purchase?	Recent Move Remodeling/Addition to home Redecoration Furniture Replacement Desire for New Furniture Second Home Marriage Divorce Other N/A
When was your last furniture purchase prior to this one?
How long have you lived in your current residence?

Would you be interested in receiving correspondence from Laneventure including product information? Yes No
If "Yes" what means of communication would you prefer? Regular Mail E-mail
May we add your name to our Customer Response Panel? Yes No Periodically we request input from members of this panel. Sometimes you could receive compensation for your participation.