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* Required
fields |
1. Store and
product details |
Date
of purchase* |
Month is required
Year is required |
Name of store where purchased |
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City |
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State |
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Sales person |
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Product name* |
Product name is required |
Product combination* |
(e.g.
3 seater and 2 recliners)
Product Combo is req'd |
Product serial
number* |
Product serial number is required |
Purchase Price |
Numbers only |
2.
Customer details |
Title*
Title is required |
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First Name*
Name is required |
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Initial |
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Surname |
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Street Address |
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Suburb |
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City |
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State |
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Post Code |
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Country |
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Email*
Email is required |
Please enter a valid email address |
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3. What was the
main reason for this purchase? |
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4. How did you
first become aware of the furniture you purchased? |
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5. How well
did the salesperson assist you in choosing your furniture? |
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6. What 3
factors most influenced your choice? |
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7. Where will
the furniture be used? |
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8. Occupation |
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You |
Spouse |
Home maker
Professional/Technical
Upper Management/Executive
Middle Management
Self Employed
Clerical
Retired
Tradesperson/Machine Operator/Labourer
Other (specify) |
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9.
Age (Please tick your age group) |
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10. Which group
describes your annual family income |
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11. For your
own primary residence, do you |
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12. Are you
happy with your new furniture? |
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13. Do you
plan to purchase other soft furniture? |
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Customer
authorisation
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As
required by the Privacy Act 1993, I agree to the retention of my
name and address details for the purpose of Morgan Furniture
improving their products and services, and if authorised, providing
further product, care and service information. The information
collected will not be passed on to any other agency, individual or
company and will remain strictly confidential to Morgan Furniture
Int Ltd.
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Do
you wish to receive future information regarding product, care and service?
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