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1.
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Native Language:
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2.
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First Name:
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Initial:
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Last Name:
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Address:
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Apt Number:
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City:
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State:
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Zip code:
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3.
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Phone:
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4.
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Email Address: (Example: yourname@yourhost.com)
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5.
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Date of Purchase:
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6.
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Model Number:
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7.
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Serial Number:
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8.
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What is the type of intended use/application for this tool?
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9.
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What do you plan on purchasing next?
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10.
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Please select the option that best describes your occupation
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11.
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Where do you usually purchase your Hitachi tools?
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12.
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Please select two (2) of the following reasons that most influenced the purchase
of this Hitachi tool. (Hold down the control key on your keyboard ("Ctrl" or "Control")
and click the mouse to make a second selection.)
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13.
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What percentage of the power tools you own are Hitachi tools?
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14.
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Your gender:
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15.
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Your marital status:
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16.
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Age?
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17.
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For your primary residence, do you:
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18.
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Which best desctibes your family income?
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19.
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Education:
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