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Purchase Information

Date of Purchase:

(mm/dd/yyyy)

Model:

Serial#:

Components Purchased:

Additional Information

Gender
Male	Female
Marital Status
Married	Single

Age	Occupation
	[select best answer] Professional/Managerial Administrative Student Proprieter Production/Tech Craftsman Sales Other
Income
[select best answer] $10,000 to $19,999 $20,000 to $29,999 $30,000 to $39,999 $40,000 to $49,999 $50,000 to $74,999 $75,000 to $100,999 $100,000 plus

What type of riding do you do?

	Commuting		Touring
	Recreation		Fitness
	Road Racing		Off-Road Racing

What publications do you read regularly?

	Velo News
	Inside Triathlon
	Runners World
	Bicycling
	Triathlete
	Outside
	Women's Sport & Fitness
	Bicyclist
	Mountain Bike
	Bike
	Backpacker
	Mountain Biker
	Shape
	MBA
	Sports Illustrated
	Men's Fitness
	Self
	Dirt Rag
	Winning
	Men's Journal
	Women's Fitness

What do you like most about your new Merlin?

What do you like least about your new Merlin?

What other Merlin products do you own?

What other products would you like Merlin to make?