Please complete the information below to help us validate your registration. Providing this information is not, however, a condition precedent to warranty coverage and performance.
(* denotes required fields)

* First Name   MI:		* Last Name
* Street Address		Apartment No.
* City		* State OR   Province   * Zip/Postal Code
Telephone Number ( ) -		* Email Address
* Dealer Name		Date of Purchase Month (1-12)   Year

1. Overall, how satisfied are you with your recent Hunter Douglas purchase(s)? Very satisfied Somewhat satisfied Neutral Somewhat dissatisfied Very dissatisfied

2. When you next purchase window coverings, how likely will you be to purchase Hunter Douglas window coverings? Very likely Somewhat likely   Not too likely Not at all likely

3. Total amount spent on your most recent Hunter Douglas purchase: Less than $500 $500 to less than $1,000   $1,000 to less than $1,500 $1,500 to less than $2,000   $2,000 to less than $2,500 $2,500 to less than $5,000   $5,000 or more

4. Type of Dealer Purchased from: Hunter Douglas Window Fashions Gallery® Specialty window covering retail store Shop-at-home service (no retail location) Furniture store (Ethan Allen, etc.) Floor covering retail store Internet Department store (JCPenney, etc.) 800#/Catalog Warehouse/wholesale club (Costco, etc.) Home center (Home Depot, Lowes, etc.) Wallpaper or paint retail store Other

5. Reason for Purchase: Decorating newly purchased home Decorating newly built home Redecorating existing home/addition Replacing old window coverings Bought for a commercial building/business Other

6. How long have you lived in your current home? Less than 6 months 6 months to less than 1 year   1 to less than 3 years 3 to less than 5 years   5 to less than 10 years 10 to less than 20 years   20 years or more