|
|
The fields with a red ( * ) are required
|
|
|
Title :
|
|
|
|
First name : *
|
|
|
|
Last name : *
|
|
|
|
Address :*
|
|
|
|
City :*
|
|
|
|
Province / State :*
|
|
|
|
Postcode :*
|
|
|
|
Country : *
|
|
|
|
Email : *
|
|
|
|
Please retype email : *
|
|
|
|
Model Purchased : *
|
|
|
|
Serial Number 7 digits: *
|
|
|
|
Where did you purchase it from? *
|
Online Retailer
Retailer
Please specific : *
|
|
|
Purchase date :
*
|
dd:
mm:
yy:
|
|
|
Were you recommended by a friend? If so enter their unique code here : UK/EIRE ONLY
|
|
|
|
|
|
What size of aquarium was the filter bought for?
|
|
|
What type of aquarium is it?
|
Freshwater
Marine
|
|
|
What species of fish do you keep in the aquarium?
|
|
|
What is the aquarium brand?
|
|
|
For how long have you been keeping fish?
|
|
|
What are your main reasons for choosing a Fluval G filter over any other brand? (tick all that apply)
|
|
|
Performance
Ease of maintenance
Quality
The Hydrotech performance monitor (LCD Screen)
EC Monitor
The Fluval brand name
I wanted to have the latest aquatic gadget
I read good reviews about it
The in-store display/demonstration
Other
|
|
|
What pets, other than aquarium fish, do you have in your household? (please check all that apply)
|
|
|
Bird(s)
|
Small Animal(s) (ie. Hamster, rabbit ...)
|
|
|
Cat(s)
|
Reptile(s)
|
|
|
Dog(s)
|
I have a pond
|
|
|
Where do you usually buy your pet supplies?
|
|
|
|
|
|
Occasionally Hagen will be releasing product and other information.
Would you like to be updated on new product releases :
|
|
|
Press release :
|
|
|
|
Delivery method :
|
|
|
|
|
|
|
|
