MAIL THIS PORTION
Your answers to the following questions are appreciated.
1. This product was purchased from:
3. How did you learn about this product:
Home Center | Other ( | ) |
Hardware/Lumber Store
Tool Distributor
Industrial Supply
Construction Supply
2. Use of the product is intended for:
Construction Trade
Industrial Maintenance
Home Maintenance
Hobby
Other ()
Magazine
From Dealer
Newspaper
Store Display
Catalog
4. Most favored points are:
Design
Features
Size
Price
Makita Brand
Radio
Exhibition
From Friend
Previous Usage
Other ()
Repair Service
Durability
Power
Other ()
5. Any comments:
Paste Paste Paste Paste Paste Paste
DATE PURCHASED |
|
|
|
|
| MODEL NO. |
|
| ||
MONTH | DAY | YEAR |
|
|
| |||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| SERIAL NO. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| STATUS |
| SEX |
INTL. LAST NAME / COMPANY NAME |
|
| Married Single | M | F |
STREET ADRESS
CITY
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| AREA |
|
|
|
|
STATE |
|
|
|
|
| ZIP CODE |
| PHONE |
|
| CODE |
|
|
|
| |||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
| ||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
AGE: |
|
|
| Under 19 |
|
|
|
|
|
|
|
|
| Over 60 | ||||||||||||
|
|
|
|
|
|
|
|
|
|
|
| |||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
BE SURE TO COMPLETE THE CUSTOMER’S PORTION OF THIS FORM AND RETAIN FOR YOUR RECORDS.
Please return this portion by facsimile or mail.
14Facsimile No: (714)
Paste Paste Paste Paste Paste Paste
Paste | Paste | Paste | Paste | Paste | Paste | Paste | Paste |
|
|
|
|
|
|
|
|