Demographic Survey...


Please take a few minutes to help us get to know you better.
This information will not be sold or otherwise used without your permission.

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    Personal Contact Information

    All personal contact responses will be kept strictly for our confidential use.

    1. Your name :

    2. Your mailing address :

    3. Your phone number :

    4. Your email address :




      Anonymous Demographic Information


    5. Number of pets in household


    6. Types of pets in household (check all that apply)
      cat
      dog
      bird
      ferret
      hamster/gerbil
      iguana
      hedgehog
      snake
      sugar glider
      other


    7. Your city :

    8. Your state or province :

    9. Your zip/postal code :

    10. Your country :

      Enter country if unlisted :

    11. Your date of birth :(MM/DD/YY)
    12. Your gender :
      Male
      Female
    13. Your level of education :
    14. Your marital status :
    15. Number of children :
    16. Individual employment income level (US$) :



      Anonymous Business Information


    17. Employment status :

      If you are employed, please give us the following information:


    18. Company's name :
    19. Company's ZIP/Postal Code :
    20. Industry :
    21. Professional title/function :
    22. Your company's size (# of employees) :
    23. Level of purchasing authority (US$) :

    Thank you...
    Please click on to register your information with us. Click on to start over.


    We appreciate you taking the time to fill out this questionnaire.



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