1. Name & Address:  
     
    * Title Mr.    Mrs.    Ms.    Miss
    * First Name Initial * Last Name
           
    * Street Apt. No. * City
    * State/Province * Zip/Postal Code
    * E-mail Address
    * Phone
  2.  
  3. Your date of birth:
  4.  
  5. Marital Status: Married Single Widowed Divorced
  6.  
  7. Date of purchase: 
  8.  
  9. Model number:
                             (see bottom of box)
  10.  
  11. Did you purchase this product yourself or receive it as a gift?
     
    Purchased it for Myself    Received as a Gift
  12.  
  13. From whom did you purchase this product?
     
    A Professional - only Beauty Supply Distributor
    A Beauty Supply Store Open to Both Professionals and Consumers
    A Trade Show
    Mail Order
    A Salon
    Other
  14.  
  15. If you bought this product from a professional - only beauty supply distributor, did you purchase it from a salon consultant in you salon or purchase it at the distributor's store?
     
    Purchased it through a salon consultant who called me at my salon
    Purchased it at the distributor's store
  16.  
  17. What is the name of the beauty supply store, distributor, trade show, mail order or other outlet where you purchased this product?


  18.  
  19. Are you a licensed Beauty Professional?
     
    Yes   License State No
  20.  
  21. Where will you use this product?
     
    In a Salon/Spa    At Home
  22.  
  23. Which of the following best describes you?
     
    Professional Hairdresser
    Professional Nail Technician
    Beauty School Student
    None of the above
  24.  
  25. If you are a professional stylist or nail technician, which best describes your current status?
     
    Work in a salon/spa as an employee
    Work in a salon/spa as a booth renter
    Salon/spa owner
    Work from home
  26.  
  27. If you are a stylist, how many stylist work in your salon, including yourself?
  28.  
  29. If you are a nail technician, how many nail technicians work in your salon, including yourself?
  30.  
  31. What hair styling aapliances do you currently own?
     
    Blow-Dryer Brand:  
    Flat Iron Brand: Size:
    Curling Iron Brand: Size:
    Crimper Brand:  
    Travel Dryer Brand:  
  32.  
  33. If you are a professional stylist, how many of each of the following tools do you purchase strictly for professional use each year?
     
     
    More than 5
    0-1
    1-2
    2-3
    3-4
    4-5
    Handheld Hair Dryers
    Curling Irons
    Flat Irons
    Electric Clippers and Trimmers
  34.  
  35. If you are a professional nail technician, how many of each of the following tools do you purchase strictly for professional use each year?
     
     
    More than 5
    0-1
    1-2
    2-3
    3-4
    4-5
    Electric Foot Baths
    Facial Paraffin Appliances
    Hand/Feet Paraffin Appliances
  36.  
  37. Not including yourself, what is the GENDER and AGE (in years) of children
    and other adults living in your household?

     
    No one else in household Child under 1 year
    1. Male Female Age (in yrs):
    2. Male Female Age (in yrs):
    3. Male Female Age (in yrs):
    4. Male Female Age (in yrs):
  38.  
  39. Occupation: (check all that apply)
     
      You Spouse
    Professional/Technical
    Upper Management/Executive
    Middle Management
    Sales/Marketing
    Clerical/Service Worker
    Tradesman/Machine Operator/Laborer
  40.  
  41. Are you or your spouse:  
     
      You Spouse
    A Homemaker?
    Retired?
    A Student?
    Self Employed/Business Owner?
    Working from a Home Office?
    In the Military?
    A Veteran?
  42.  
  43. Which group describes your annual family income?
     
    Under $15,000
    $15,000-$19,999
    $20,000-$29,999
    $30,000-$39,999
    $40,000-$49,999
    $50,000-$59,999
    $60,000-$74,999
    $75,000-$99,999
    $100,000-$124,999
    $125,000-$149,999
    $150,000-$174,999
    $175,000-$199,999
    $200,000-$249,999
    $250,000 & over
  44.  
  45. Level of education: (select highest level completed)
     
    Completed High School
    Completed College
    Completed Graduate School
  46.  
  47. Which credit cards do you use regularly?
     
    American Express, Diners Club
    MasterCard, Visa, Discover
    Department Store
    Do not use credit cards
  48.  
  49. For your primary residence, do you:
     
    Own? Rent?
  50.  
  51. How recently did you move into your current residence?
     
    Within 30 days
    Within 1-3 months
    Within 4-6 months
    7 to 12 months ago
    Have not moved in the last 12 months
  52.  
  53. Which of the following do you plan to do within the next 1-6 or 7-12 months?
    (select all that apply)
     
     
    1-6 Months
    7-12 Months
    Buy/Lease a New Vehicle
    Buy/Lease a Used Vehicle
  54.  
  55. Please check all that apply to your household.
     
    Shop by Catalog/Mail
    Shop via the Internet
    Member of Frequent Flyer Program
    Donate to Charitable Causes
    Own a Compact Disc Player
    Have a Dog
    Have a Cat
    Own a Wireless/Cellular Phone
    Speak Spanish
    Own an Apple/Macintosh Computer
    Own a CD-ROM Drive
  56.    
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