First Name: Last Name: Street Address:
City: State

Zip:
Email Address: Phone: Age:

 
Gender: Household income: Marital status:
     
Please tell us which of the outdoor activities you are involved in:
Fly Fishing Camping Skiing
Fishing (salt water) Hiking All Terrain Vehicle
Hunting Backpacking Canoeing
Boating Climbing    
           
How many times per year do you participate in these activities?


If you own your own equipment do you buy online or retail?
online retail		 Do you own or rent your own equipment?
Rent
Own
Both

How much of your time do you dedicate to your outdoor activity?
Once a year 6 times a year
Twice a year Weekly
3 times a year Monthly

Which do you prefer for your day and overnight accommodations?
Travel Agency Package deals Campsite Deals
Hotel deals Fishing Charters
Airline offers    
Please indicate if you own or rent any of the below
Auto (thru car rental agency)   Skis
Boat   RV Campers
Canoe        
Do you recieve mail order catalogs?
Yes No
Do you purchase Bass fishing products from catalogs?
Yes No


Thank you for your time. The information you provided will help us bring you only targeted offers that will save you time in your busy schedule.

Unless I have checked any of the boxes below, Take 5 Solutions, LLC will assume that I do not mind receiving online, postal or SMS offers:
  
I would prefer not to receive online offers, product information,
specials, updates from third party advertisers
 
I would prefer not to receive postal offers, product information,
specials, updates from third party advertisers