Diamondback MULTI-SPEED - Page 36

What is your bike’s serial number?
(see diagram on inside front cover for location)
Date of
Purchase:
Month
Day
Year
What model bike do you have?
Assault
Axis
Century
Della Cruz 2.0
Edgewood
Kalamar
Mission 1
Mission 2
Octane
Peak
Podium 1
Podium 2
Podium 5
Response
Response Comp
Strike DH
Wildwood
Wildwood DLX
XSL
What is your bike’s
model year?
Purchased from
(
dealer name
)
?
Dealer’s
state:
What is your bike’s serial number?
What is your bike’s serial number?
What is your bike’s serial number?
Price paid
(
excluding sales tax
)
:
Reasons you purchased a Diamondback:
Received as a gift
Received as a gift
Color/Appearance
Color/Appearance
Quality/Durability
Quality/Durability
Comfort/Fit
Comfort/Fit
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Frame/Design/Materials
Frame/Design/Materials
Family/Friend Recommendation
Family/Friend Recommendation
Value/Price
Value/Price
Component selection
Component selection
Weight of bicycle
Weight of bicycle
Prior experience with brand
Prior experience with brand
Sales person’s recommendation
Sales person’s recommendation
Diamondback’s Reputation
Diamondback’s Reputation
Other
Other
Other brands considered ?
.
0
0
$
First Name:
Middle
Initital:
Last Name:
Gender:
Male Female
Male Female
Daytime phone:
-
-
Evening phone:
-
-
Marital status:
Married Single
Married Single
Street
Address:
Street & Apt No.
City
Date of birth:
Month
Day
Year
Email
Address:
State
Zip Code
Country
Coil 24
Maravista
Octane 24
Podium 3
Response Sport
Wildwood Citi
Coil EX
Menona
Outlook
Podium 4
Sorrento
Wildwood Tandem
Please Register Your Bike Online At www.diamondback.com
If you do not have access to a computer, please complete the form below and return within the next 10 days. Notates required  elds.
*
*
*
*
*
*
*
What is your bike’s serial number?
*
What is your bike’s serial number?
*
*
XTS Moto
Other (specify)
XSL Trail
XTS
*
Professional/Technical
Upper Management/Executive
Middle Management
Sales/Marketing
Occupation
(Check all
that apply)
:
You Spouse
Clerical/Service Worker
Tradesman/Machine Operator/Laborer
Student
Housewife
You Spouse
Annual
Income:
$20,000 – $50,000
$20,000 – $50,000
$50,000 – $75,000
$50,000 – $75,000
$75,000 – $100,000
$75,000 – $100,000
Over $100,000
Over $100,000
Under $20,000
Under $20,000
Retired