Do you currently own a sprayer?    Yes  No

If yes, what kind?    Walker   Other:

Are you in the market for a sprayer?    Yes  No

If yes,   New   Used

What price range?

    $0 - $50,000
    $50,000 - $60,000
    $60,000 - $70,000
    $70,000 - $80,000
    $80,000 - more
    I am not currently in the market.

Would you like literature sent to you?   Yes  No

Would you like to be contacted by one of our salesmen?   Yes  No

Enter your comments or concerns in the space provided below:

Tell us how to get in touch with you:

Name
Address 1
Address 2
City,State
ZIP Code
E-mail
Tel
FAX

Please contact me as soon as possible regarding this matter.