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Salutation First Name Last Name E-mail Daytime Phone

Address City State Zip Country

Products purchased (if you have purchased a system or multiple products, list each serial #)
Model No. Serial No.(if available)  
 
 
 
 
 
 

Where did you acquire this/these RBH product(s)?
Date of purchase Dealer Name Dealer Location (City) (State) (Zip)

Who installed your RBH product?
Dealer/Professional I installed it myself A friend Other

What was the main reason that influenced your purchase of this RBH product?
(please check all that apply )
RBH Reputation Recommendation of dealer Technical Specifications
Sound Quality Recommendation of family/friend Value for price
Appearance Magazine review Prior experience with RBH

What other brands did you consider?

Where did you hear of RBH? (please check one below )
Internet Word of Mouth Gift
Internet Advertisement Dealer/Installer It came with my house
Magazine Advertisement Installer’s bid Other  

Are you interested in having someone from RBH contact you regarding extending your warranty?
(please check one below )
Yes – contact me by e-mail (address used above) Yes – by telephone. (number used above)
Yes – mail it to me. (address used above) No thanks.

Did you have any trouble or problems setting up or using this/these products?
(please check one below )
Yes (If yes, please describe the problem below) No



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