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1. Name & Address
* Title    Mr.  Mrs.  Ms.  Miss 
* First Name
Initial
* Last Name
* Street
Apt. No
* City
* State/Province
* Zip/Postal Code
Email Address
 
2. Telephone Number:  (  )  - 
(Note: This will not be used for telemarketing purposes.)
 
3. * Date of purchase:        
 
4. * Model name and number:
 
5. * Serial or Manufacturer code:  
 
6. * a) Store where purchased:  
   b) If purchased ONLINE, Website:  
 
7. * Price paid (excluding sales tax):  $  .00
 
8. Have you ever owned a pool table before?
Yes    No
 
9. Make and model?
American Made
Far East import
Other
 
10. Select the 3 most important factors influencing your purchase of this product.
(check a maximum of 3)
 Brand reputation  Salesperson's recommendation
 Prior experience with Beringer  TV Ad
 Style/Color/Appearance  Magazine Ad
 Price  Newspaper Ad
 Special features/attachments  Radio Ad
 Warranty  Special promotion/Value added
 Quality/Durability  Store display
 Ease of Customer Service  Made in the North America
 Friend's/Relative's recommendation  Other 
 
11. What other brands did you seriously consider before making this purchase?
 
12. How would you rate the Table Installers?
Good Fair
Professional/Technical?
Courteous?
Tidied up after completion?
Answered all your questions?
Dressed in a professional manner?
Felt that your experience was good overall?
 
13. Suggestions on how we may improve in future:
 
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