Consumer Information
* First Name:
* Last Name:
Address:
City:
State:
Zip:
Phone:
Email:
Occupation:
Age:
Under 25
Between 25 and 40
Between 41 and 50
Between 51 and 60
Over 60
Marital Status:
Married
Single
Divorced/Widowed
Income:
Less than 25,000
25,000-34,999
35,000-44,999
45,000-54,999
55,000-74,999
75,000-99,999
100,000-149,999
150,000-249,999
250,000+
On a scale of 1 to 7 with 1 being "I strongly agree" and 7 being "I strongly disagree",
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2
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5
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7
A. I care more about how my home looks than most people.
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2
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5
6
7
B. It's important to me that my whole house be a place where kids can be kids.
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5
6
7
C. I'm still trying to make my home the home I've always wanted.
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3
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5
6
7
D. I'll never be satisfied with how the inside of my home looks.
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5
6
7
E. Impractical furniture is ok as long as it is especially attractive.
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5
6
7
F. If furniture cannot stand up to some use and abuse, it doesn't belong in my house.
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5
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7
G. When I buy furniture, I am thinking about how it will look to visitors and guests.
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5
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7
H. I think a home is more appealing when it has a mixture of styles.
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7
I. Shopping for furniture and accessories is a way for me to be creative.
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5
6
7
J. I find shopping for furniture intimidating.
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7
K. I don't have the time or interest to worry about decorating.
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5
6
7
L. Friends sometimes ask my advice or opinion about home furnishings and decoration.
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7
M. We often have cookouts at our home.
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5
6
7
N. I consider myself a compassionate person.
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6
7
O. Being organized and punctual is an important part of character.
Retailer Name:
City and State:
Date of Purchase:
How did you become aquainted with Laneventure?
What were the most important features that prompted you to purchase this Laneventure product?
What improvements could be made to this product?
When was your last furniture purchase prior to this one?
Within last 6 months
Within last year
Within last 2 years
How long have you lived in your current residence?
Under 1 year
1-5 years
5-10 years
Over 10 years
Would you be interested in receiving correspondence from Laneventure including product information?
If "Yes" what means of communication would you prefer?
May we add your name to our Customer Response Panel?
Periodically we request input from members of this panel.
