Title:
First Name* and
Last Name*:
Address*:
City, State, Zip:
E-mail*:
Daytime Phone*:
Evening Phone:
Marital Status:
Date of Purchase:
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January
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June
July
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September
October
November
December
Purchase Price:
$
UPC number*:
899071-
Place of Purchase:
Which one of the following products did you purchase?
Select One
Clarity Skin Rejuvenation Light
Per3 Deluxe Light Therapy Lamp
SunTouch Plus Light & Ion Therapy
What is the most important deciding factor in purchasing NatureBright?
(Please number 1-10 in order of importance - 1 being important)
What other brands do you think that carry similar products to NatureBright?
Where did you hear of NatureBright?
Describe yourself:
one adult/no children
one adult with children
two or more adults
couple/no children
couple with children
Your Age:
Younger than 18 years
18 to 35 years
35 to 60 years
60 to 80 years
Older than 80 years
Occupation:
Annual combined income:
Under $50,000
$50,000-$74,999
$75,000-$99,999
$100,000-$124,999
$125,000-$149,999
$150,000-$299,999
$300,000 +
Level of education:
High School
College
Graduate School
For your primary residence, do you:
How long have you lived at your current residence?
6 months
7 - 12 months
1 - 2 years
3 - 5 years
5 years +
Your shopping style:
(check your most frequent shopping style)
If you shop online, which site do you use most:
"Do you have any suggestions for new products or improvements to the existing products for NatureBright?
