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become eligible to win $5000 worth of hooker furniture

On behalf of all the employees at Hooker Furniture Corporation, we thank you for purchasing our furniture. Your retailer can assist you in many areas. We would, however, like to know more about you. Therefore, we ask you to complete the following questionnaire. This will register your purchase, and you will become eligible for twice-yearly drawings for $5000 worth of Hooker furniture through the dealer from whom you purchased this product. Please note that your responses will be used for our purposes only. No names will be sold to outside mailing companies.

Your Information

Please note that your information is used for contact purposes only. You information will not be sold to outside mailing companies.

* Required Information

*Please include the item number in the above field if possible

Male Female Joint Purchase

Married Single Divorced

Single Family House Apartment Condominium Other

Own Rent

Under age 13 Over age 13

Product Purchased Information

Prestige of manufacturer or the product made by them Prestige of retailer from whom you bought the product Design of the product: styling, finish, engineering, etc. Quality of the product Service of the retailer Price of the product

Advertising Company Signs, Hang Tags, Brochures, Product Information Retail Sales Person Friend/Relative In Store Furniture Display Internet Other

Yes No Unsure

Yes No

Within last 6 months Within last year Within last 2 years

Very likely Somewhat likely No opinion Somewhat unlikely Very unlikely

Very likely Somewhat likely No opinion Somewhat unlikely Very unlikely

Yes No Unsure

I care more about how my home looks than most. It is important to me that my whole house be a place where kids can be kids. I am still trying to make my home the home I've always wanted. I'll never be satisfied with how the inside of my home looks. Impractical furniture is okay as long as it is especially attractive. If furniture cannot stand up to some use and abuse, it doesn't belong in my house. When I buy furniture, I'm thinking about how it will look to visitors and guests. I think a home is more appealing when it has a mixture of styles. Shopping for furniture and accessories is a way for me to be creative. I find shopping for furniture to be intimidating. I don't have the time or interest to worry about decorating. Friends sometimes ask my advice or opinions about home furnishings and decoration. We often entertain or have guests/family over. I consider myself a compassionate person. Being organized and punctual is an important part of character.

Yes No

Yes No

Questions or Comments

Please be as specific as possible regarding your requests, questions or comments.