Please complete this SHORT survey for your discount:

1.
How did you find our website?
Search engine. Which one:
Keyword searched:

Website listed on the product
Link from this website:

Ads in this magazine:

Other:
2.
This purchase is for:
Myself. Age:
Sex:

Family member. Whom:
Age:

Friend. Select:

Other:
3.
Were children a factor in the purchase decision?
Yes
No
4.
Where did you first see this product?
Online
In a shop. Type of Shop:

In someone's home / office
Mail order catalog. Which one:

Newspaper / magazine / TV. Which one:

Other
5.
Have you purchased HeadsUp products before?
Yes, Which one:
MooCoo Clock
EweCoo Clock
CluckCoo Clock
OinkCoo Clock
OranguCoo Clock
AaaahCoo Clock
WhinnyCoo Clock
BarkCoo Clock
EleCoo Clock
Hannah Holstein Clothes Hook
Harley Hog Clothes Hook
Harley Hog Toothbrush Holder
Dexter Duckling TP Holder
Harley Hog Cord Pull
Sidney Swan Cord Pull

No
6.
Where will this product be used?
Kitchen
Living room
Bedroom
Bathroom
Office
Other

Don't know
7.
The user of this product lives in:
Countryside
Suburb
City
8.
Would you like to be informed when we launch new products or have special offers?
Yes, E-Mail:

No
9.
Any Comment:
10.
I would like to be eligible for a promotional discount in HeadsUp's...
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