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* 1. Please enter the following information:

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* 2. Product Code Number (product code is located just above the UPC bar code on the product carton/box)

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* 3. Serial Number

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* 4. Date of Purchase

Date

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* 5. Name of store where purchased

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* 6. Was your purchase made via the internet?

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* 7. Purchase Price

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* 8. Would you like to periodically receive e-mail updates on Winchester Repeating Arms products and promotions?

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* 9. What are the outdoor interests and activities of your household? (check as many as apply)

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* 10. How many times per month do you participate in outdoor interests?

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* 11. What printed magazines do you read regularly? (check as many as apply)

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* 12. What will be the primary use for the product just purchased?

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* 13. How many days per year will your new Winchester firearm be used?

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* 14. How many total firearms do you own?

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* 15. How many Winchester firearms do you own?

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* 16. Gender

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* 17. Marital Status

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* 18. What is your age?

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* 19. What is the number of people in your household, including yourself?

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* 20. Do you rent or own your primary residence?

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* 21. How would you describe your place of residence?

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* 22. What is your occupation?

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* 23. Which group best describes your annual income?

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* 24. Education

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* 25. Did you find the Winchester Repeating Arms website to be?

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* 26. What do you use the internet for? (check all that apply)

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* 27. What factor most influenced your purchase?

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* 28. What could we do to improve this product?

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* 29. Will you purchase Winchester firearms again?

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* 30. I would like to receive information from companies whose products and services relate directly to the specific interests, hobbies and other information indicated above.

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