First Name *
Last Name *
Street Address *
Apartment / Suite
City *
State / Province *
Zip / Postal *
Country *
Email Address *

Do you plan on purchasing a rug within the next...*
3 months
6 months
12 months
Not planning on purchasing a rug

Please indicate which of the following is most important to you when selecting a rug for your home
Style (i.e. Persian, Chinese, Tibetan etc.)
Material (i.e. silk, wool, cotton, synthetic)
Price
Delivery
Manufacturing Process (i.e. handmade, machine-made)
Warranty
Company

How frequently do you shop online?
Daily
Weekly
Monthly
Every three months
Every six months
Yearly
Never shop online
Other
Other - please describe:

If you do shop online, what type of online stores do you frequent? (Check all that apply)
Groceries
Books, music, DVDs
Clothing
Household items
High end items

In which age category do you belong? *
Under18
18 to 24
25 to 34
35 to 49
50 to 65
Over 65

For statistical purposes only, please indicate which category best describes your total household income.
Under $30,000
$30,000 to $40,000
$40,000 to $60,000
$60,000 to $80,000
$80,000 to $100,000
Over $100,000

Please indicate your gender *
Male
Female

Where did you hear about Rugman.com? *
Online Ad
Brochure
Word of mouth
Search engine
Link from another site
Other
Other - please describe:

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