Name:
Address:
Suburb:
State:
Phone:
E-mail:
Model Purchased:
Date Purchased:
Batch No:
Store Purchased:
Store Suburb:
To assist us in bringing you the product features that you want, we would also be
grateful if you could complete the following short questionnaire:
1. Is this the first Uccello product you have ever owned?
_______________________________________________________________________
_______________________________________________________________________
2. What were the TWO most important factors influencing the choice of this product?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
3. What was the Main reason for your purchase?
_______________________________________________________________________
_______________________________________________________________________
4. Would you like to recieve additional information about Uccello products and new
developments? Circle option
YES/NO
