
HEY!!! C R A S H R E P L A C E M E N T P R O G R A M |
|
R E G I S T E R H E R E F O R G I R O ' S | 83F |
1What helmet did you buy?
1. |
|
| Ravine™ 2. |
| Chute™ | 3. |
| Pitch™ 4. |
|
| Bugaboo™ 5. |
|
| Flint™ 6. | ||||||||||||||||
|
|
|
|
|
| |||||||||||||||||||||||||
2 1. |
|
|
| Mr. | 2. |
|
| Ms. | 3. |
|
|
| Miss | 4. |
| Ms. | ||||||||||||||
|
|
|
|
|
| |||||||||||||||||||||||||
|
|
|
|
|
|
| First Name: |
|
|
|
| Initial: |
| Last Name: | ||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Nine™
3 | Address/Number and Street: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Apt.#: | |||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| City: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| State: |
|
| Zip: | |||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Phone Number: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| ||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |||||||||
4 | Date of Purchase: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |||||||||||
|
|
|
|
|
|
|
|
|
|
| month | year |
|
|
|
|
|
| |||||||||||||||||||||||
5 | Serial Number: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| (located on hard shell, under ear pad) | ||||||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |||||||||||||||||||||||||
6Why did you choose this helmet? (top 2 reasons)
| 1. |
| Received as a gift | 4. |
| Quality/Durability |
| 7. |
| Great Ventilation | |||||||
|
|
|
|
| |||||||||||||
| 2. |
| Crash Program |
| 5. |
| Great Fit |
| 8. |
| Salesperson rec. | ||||||
|
|
|
|
|
| ||||||||||||
| 3. |
| Color/Graphics |
| 6. |
| It's a Giro |
| 9. |
| It's Lightweight | ||||||
|
|
|
|
|
| ||||||||||||
|
|
|
|
|
| ||||||||||||
7 | Is this your: | 1. |
|
| First snowsport helmet | 2. |
| Replacement helmet | |||||||||
|
|
| |||||||||||||||
|
|
| |||||||||||||||
8 | Is this your first Giro helmet? | 1. |
| Yes | 2. |
| No |
| |||||||||
|
|
| |||||||||||||||
|
|
| |||||||||||||||
9What other brands did you consider?
1. |
| Bell | 4. |
| Carrera | 7. |
| Jofa | |
|
|
| |||||||
|
|
| |||||||
2. |
| Boeri | 5. |
| Leedom | 8. |
| RED (Burton) | |
|
|
| |||||||
3. |
| Briko | 6. |
| Louis Garneau | 9. |
| Other |
|
|
|
| |||||||
|
|
|
| ||||||
10How many days per year do you snowboard or ski?
1. |
| 2. |
| 3. |
| 4. |
| More than 20 days/year | |||
|
|
|
|
11For which sports/activities will this helmet be used?
1. |
| Snowboarding | 2. |
|
| Sking | 3. |
| 4. |
| Other | |||||||
|
|
|
|
| ||||||||||||||
|
|
|
|
| ||||||||||||||
12 Your Date of Birth: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| ||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |||
month |
|
| day |
| year |
|
|
| ||||||||||
|
|
|
|
|
|
|
|
| ||||||||||
13What other sports do you participate in?
1. |
| Road Cycling | 5. |
|
|
| Hiking | 9. |
|
|
|
| Golf | |
|
|
| ||||||||||||
2. |
| Mountain Biking | 6. |
|
|
| Backpacking | 10. |
|
|
|
| Team Sports | |
|
|
|
|
| ||||||||||
3. |
| Running | 7. |
|
|
| Tennis | 11. |
|
|
|
| Motor Sports | |
|
|
|
|
|
|
|
| |||||||
4. |
| Inline Skating | 8. |
|
|
| Skateboarding | 12. |
|
|
|
| Other |
|
|
|
|
|
|
|
|
|
| ||||||
14Including children, what are the ages of the other people that live in your house?
Male: |
|
|
|
|
|
|
|
| years | Female: |
|
|
|
|
|
|
|
| years |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
15Education (please check categories which apply):
1. |
| High School | 3. |
| Completed College |
|
| ||||
|
| ||||
2. |
| Some College | 4. |
| Graduate School |
|
| ||||
|
|
16Which best describes your family income?
1. |
| Under $15,000 | 4. |
| 7. |
| ||
|
|
| ||||||
|
|
| ||||||
2. |
| 5. |
| 8. |
| Over $150,000 | ||
|
|
| ||||||
|
|
| ||||||
3. |
| 6. |
|
|
|
| ||
|
|
|
|
| ||||
|
|
|
|
|
17In the last six months have you or others in your household:
1. |
| Purchased clothes through the mail? | 6. |
| Purchased two or more books? |
|
| ||||
2. |
| Purchased gifts through the mail? | 7. |
| Purchased casettes/CDs? |
|
| ||||
3. |
| Worked in your garden? | 8. |
| Donated to wildlife or |
|
| ||||
|
| ||||
4. |
| Traveled on vacation |
|
| environmental causes? |
|
| ||||
|
| ||||
5. |
| Purchased PC or PC software? | 9. |
| Donated to charities? |
|
| ||||
|
|
THANK YOU FOR FILLING OUT THIS QUESTIONNAIRE. WE VALUE YOUR ANSWERS AND INPUT. PLEASE CHECK HERE ![]()
IF YOU WOULD PREFER NOT TO PARTICIPATE IN FURTHER MARKET RESEARCH FOR GIRO OR OBTAIN INFORMATION ON NEW AND INTERESTING OPPORTUNITIES.