Honeywell HW4000 Owners Manual - Page 4

Demographic Information

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3 - DEMOGRAPHIC INFORMATION GENDER: … MALE … FEMALE MARITAL STATUS: … MARRIED … SINGLE DATE OF BIRTH: / / MM DD YYYY INCLUDING YOUR SELF, HOW MANY PEOPLE LIVE IN YOUR HOUSEHOLD? NUMBER OF CHILDREN UNDER 18 LIVING IN YOUR HOUSEHOLD: PRIMARY RESIDENCE: … OWN … RENT EDUCATION … SOME HIGH SCHOOL … HIGH SCHOOL DIPLOMA … COLLEGE DEGREE … GRADUATE DEGREE HOUSEHOLD INCOME … LESS THAN $15,000 … $15,000 - $29,999 … $30,000 - $49,999 … $50,000 - $79,999 … $80,000 - $99,999 … $100,000 - $124,999 … $125,000 - $149,000 … $150,000 - $174,999 … $175,000 - $199,999 … $200,000 OR OVER PRIMARY METHOD OF PURCHASING HOUSEHOLD ITEMS: … IN-STORE … ONLINE … TV … MAIL ORDER TYPES OF CREDIT CARDS HELD BY HOUSEHOLD MEMBERS: … VISA/MASTER CARD … DISCOVER … AMERICAN EXPRESS … GAS/RETAIL … OTHER … NONE HOUSEHOLD INTERESTS: … HOME IMPROVEMENT … AUTOMOTIVE WORK … CAMPING … OTHER: THANK YOU FOR REGISTERING YOUR PRODUCT. THE INFORMATION YOU PROVIDED MAY BE USED FOR MARKETING PURPOSES IN ORDER TO OFFER YOU VARIOUS PRODUCT INFORMATION AND OFFERS. … CHECK HERE IF YOU DO NOT WISH TO BE CONTACTED ABOUT SPECIAL OFFERS. PLEASE RETURN THIS FORM TO THE FOLLOWING ADDRESS: Northshore Power Systems, LLC 4425 N Port Washington Road Suite 105 Milwaukee WI 53212-1082 PLEASE MAIL THIS FORM IN A SEALED ENVELOPE. DO NOT STAPLE.

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3 – DEMOGRAPHIC INFORMATION
GENDER:
±
MALE
±
FEMALE
MARITAL STATUS:
±
MARRIED
±
SINGLE
DATE OF BIRTH:
/
/
MM
DD
YYYY
INCLUDING YOUR SELF, HOW MANY PEOPLE LIVE IN
YOUR HOUSEHOLD?
NUMBER OF CHILDREN UNDER 18 LIVING IN YOUR
HOUSEHOLD:
PRIMARY RESIDENCE:
±
OWN
±
RENT
EDUCATION
±
SOME HIGH SCHOOL
±
HIGH SCHOOL DIPLOMA
±
COLLEGE DEGREE
±
GRADUATE DEGREE
HOUSEHOLD INCOME
±
LESS THAN $15,000
±
$100,000 - $124,999
±
$15,000 - $29,999
±
$125,000 - $149,000
±
$30,000 - $49,999
±
$150,000 – $174,999
±
$50,000 - $79,999
±
$175,000 – $199,999
±
$80,000 - $99,999
±
$200,000 OR OVER
PRIMARY METHOD OF PURCHASING HOUSEHOLD
ITEMS:
±
IN-STORE
±
ONLINE
±
TV
±
MAIL ORDER
TYPES OF CREDIT CARDS HELD BY HOUSEHOLD
MEMBERS:
±
VISA/MASTER CARD
±
DISCOVER
±
AMERICAN EXPRESS
±
GAS/RETAIL
±
OTHER
±
NONE
HOUSEHOLD INTERESTS:
±
HOME IMPROVEMENT
±
AUTOMOTIVE WORK
±
CAMPING
±
OTHER:
_________________________________________
THANK YOU FOR REGISTERING YOUR PRODUCT. THE INFORMATION YOU PROVIDED MAY BE USED
FOR MARKETING PURPOSES IN ORDER TO OFFER YOU VARIOUS PRODUCT INFORMATION AND
OFFERS.
±
CHECK HERE IF YOU DO NOT WISH TO BE CONTACTED ABOUT SPECIAL OFFERS.
PLEASE RETURN THIS FORM TO THE FOLLOWING ADDRESS:
Northshore Power Systems, LLC
4425 N Port Washington Road
Suite 105
Milwaukee WI
53212-1082
PLEASE MAIL THIS FORM IN A SEALED ENVELOPE. DO NOT STAPLE.