SurveyMonkey Powered Online Survey

Please register your Graco product by filling out the information below.

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* 1. About You

First Name: *

Last Name: *

Title:

Company:

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* 2. Mailing Address

Address:

City: *

State/Province: *

Zip/Postal Code:

Email Address:

Phone Number:

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* 3. Country

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* 4. Part Number(s) of Product Purchased
(Refer to instruction manual or label on box above barcode. i.e. 203876)

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* 5. Date of Purchase:

Please indicate the date purchased.

Date

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* 6. Fluid(s) You Use

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* 7. Industry (Please select the best answer from the choices provided)

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* 8. Purchased From:

Company:

City:

State/Province:

-OR- Website if purchased online:

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* 9. What were the most important factors that influenced your selection of this product?
(Select up to 3.)

Quality

Warranty

Packaging

Advertising

Availability

Features

Price

Online Research

Brand

Recommendation

Appearance/Design

Previous Experience

Item on Sale

Size

Ease of Operation

Value for the Price

Innovations

Other (please specify)

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* 10. Comments:

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* 11. We will keep your information confidential and only use it to register your product and send you updates. May we send you information on new products, updates and promotions?

Yes, send me updates

Thank you. We appreciate your business.

Please click the "Submit" button below to register your product.

Question Title

* 1. About You

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* 2. Mailing Address

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* 3. Country

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* 4. Part Number(s) of Product Purchased (Refer to instruction manual or label on box above barcode. i.e. 203876)

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* 5. Date of Purchase:

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* 6. Fluid(s) You Use

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* 7. Industry (Please select the best answer from the choices provided)

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* 8. Purchased From:

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* 9. What were the most important factors that influenced your selection of this product? (Select up to 3.)

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* 10. Comments:

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* 11. We will keep your information confidential and only use it to register your product and send you updates. May we send you information on new products, updates and promotions?

* 4. Part Number(s) of Product Purchased
(Refer to instruction manual or label on box above barcode. i.e. 203876)

* 9. What were the most important factors that influenced your selection of this product?
(Select up to 3.)