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	First Name: Middle Int: Last Name: Street: APT NO. City: State: Zip / Postal Code: Phone Number: E-mail Catalog Number: Serial Number: Date of Purchase: Purchased From: Size of Pond? What Product did you purchase? How many fish?       Currently Owned UV Products   Type of UV Sterilizer Type of Filter Type of Pump Here at Aqua Ultraviolet we are interested in your comments about our products. Please take the time to complete this questionnaire to help us satisfy your needs.   Where did you purchase this product? 1.Contractor Supply   4.Pond Supply   7.Home Center 2.Pet Supply   5.Hardware Store   8.Mail Order 3.Industrial Supply   6.Building Supply   9.Other   How did you first learn about this Aqua Ultraviolet product? 1.Previous Owner  2.Distributor's Recommendation  3. Friend's Recommendation 4. Job Site Demonstration   5. Radio, TV, Newspaper Ad  6.Trade Journal 7.Store Display  8.Trade Show  9.Distributor's Catalog  10.Other   Is this your first purchase of an Aqua Ultraviolet Product? Yes   No   What new product or accessory would you like Aqua Ultraviolet to offer?   Did the packaging of this product meet your satisfaction ?   yes no   Were all the required parts and instructions include with your product ?   yes no   Were the instructions clear and informative to your needs?   yes no   Did you install the product yourself?   yes no   Name installer.     Please add any comments you want Aqua Ultraviolet to be aware of: