Canadian Electric Outboard Motor Survey

1.For the purpose of contacting the prize winner, please fill out the contact information below (your contact information will not be used for any other purpose):

First Name:

Last Name:

Email Address:

Phone Number:

2.Your Personal Details (optional):

Gender:

Age:

City:

Province:

4.Are you a member of the Marine Trade (Boating Industry)?

Yes

No

5.Boating Industry Segment (If Applicable):