CUSTOMER & PURCHASE INFORMATION 顧客及購買資料 Please provide us with your purchase information in English. Thank you. 請用英文正楷填寫 Title 稱謂 Mr 先生 Ms 小姐 Mrs 女士   Last name 姓名  First name 名稱 Tel. no. 電話號碼 Fax. no. 傳真號碼 Address 地址  Email address 電郵  @ Model  產品型號 - Please Select - Altec Lansing UHP101 Earbuds Altec Lansing UHP301 Earbuds Altec Lansing UHP304 Headphones Altec Lansing UHP306 Earphones Altec Lansing UHP307 Earclips-S Altec Lansing UHP336 Earphones Altec Lansing UHS306 Earphones Altec Lansing UHS307 Earclips-S Altec Lansing IMT207 ORBIT SPEAKER Altec Lansing IMT217 NOBI SPEAKER Altec Lansing IMT525 SoundBlade Bluetooth Speaker Altec Lansing T612 iPhone Speaker Bluelouge - The Sanctuary Charging System DUALphone 3088 Main Base DUALphone 3088 Extra Handset CERULEAN TX + RX CERULEAN RX GameCom P20 Headset for Sony PSP iHome iH19 portable system for iPod iHome iH8WB home system for iPod iHome iH5WB home system for iPod iHome iH26WB travelers system for iPod iHome iH27 travelers system for iPod iHome iHM3 speaker for iPod and MP3 player iHome iP27 travelers system for iPhone/iPod iHome iP99 home system for iPhone/iPod iLuv i552 Portable iPod speaker with Radio iLuv i177 iPod alarm clock with Radio iLuv i601 iPod nano battery with silicon skin iLuv i603 iPod 5g 30GB battery with silicon skin iPet YAY110S Mavizen MyBlu (Bluetooth+Remote+Radio) for iPod Optimus Mini 3 - Animated OLED Keyboard Rex Remote Control Plantronics Explorer 220 Bluetooth Headset Plantronics Explorer SL220 Bluetooth Headset Plantronics Explorer 230 Bluetooth Headset Plantronics Explorer 320 Bluetooth Headset Plantronics Explorer 330 Bluetooth Headset Plantronics Explorer 340 Bluetooth Headset Plantronics Explorer 350 Bluetooth Headset Plantronics Explorer 360 Bluetooth Headset Plantronics Explorer 370 Bluetooth Headset Plantronics Voyager 510 Bluetooth Headset Plantronics Voyager 510WS Bluetooth Headset Plantronics Voyager 510WS PRO Bluetooth Headset Plantronics Voyager 510SL Bluetooth Headset System Plantronics Voyager 520MP Bluetooth Headset Plantronics Voyager 815AIQ Bluetooth Headset Plantronics Voyager 835DM Bluetooth Headset Plantronics Voyager 855AIQ Bluetooth Headset Plantronics Voyager 855AIQ iPod Edition Plantronics Voyager 855AIQ Limited Edition Plantronics .Audio 310 Multimedia Headset Plantronics .Audio 310 USB Multimedia Headset Plantronics .Audio 500 USB Multimedia Multi-Tasker's Headset Plantronics .Audio 510 USB Ultimate Performance Headset Plantronics .Audio 910 Bluetooth Headset + USB dongle Plantronics .Audio 920 Bluetooth Headset + USB dongle Plantronics Pulsar 260 Bluetooth Stereo Headphone Plantronics Pulsar 590A Bluetooth Stereo Headphone Plantronics Discovery 610 Bluetooth Headset Plantronics Discovery 640 Bluetooth Headset Plantronics Discovery 640X Bluetooth Headset Plantronics Discovery 645 Bluetooth Headset Plantronics Discovery 650MP Bluetooth Headset Plantronics Discovery 655 Bluetooth Headset Plantronics Discovery 665AIQ Bluetooth Headset Plantronics Discovery D925 Bluetooth Headset Plantronics Discovery D925 Limited Edition Vodafone VBH-300 Bluetooth Headset Vodafone VBH-600 Bluetooth Headset Vesta-life Ladybug iPod Speaker INFINXX mini 300 1.2 wireless headset for mobile phones INFINXX mini 800 2.0 Bluetooth Headset INFINXX scala 500 1.2 wireless headset for mobile phones INFINXX icombi 800 1.2 wireless stereo headphone for iPod INFINXX icombi 800 1.2 wireless stereo headphone for PSP or multimedia devices INFINXX visor 500 DSP Bluetooth Speakerphone INFINXX scala rider 1.2 wireless headset for motorbike riders INFINXX iBase 300 Bluetooth Audio Gateway INFINXX iDongle 1.2 USB stereo dongle INFINXX icombi AG12 dongle for PSP or multimedia devices INFINXX icombi AP21 dongle for iPod INFINXX AP23 dongle for iPhone/iPod INFINXX ID8SIM DECT Phone INFINXX ID8 COLOUR DECT PHONE INFINXX ID8WH Wireless Headset INFINXX ID3 DECT PHONE INFINXX ID3WH WIRELESS HEADSET INFINXX ID3SE DECT PHONE + HEADSET INFINXX ID3EH DECT EXTRA HANDSET DAEWOO ADP1200 DECT Phone DAEWOO ADP3100 SMARTDECT PHONE DAEWOO ADP3101 SMARTDECT EXTRA HANDSET Daewoo ADP-5000 SmartDECT colour Daewoo ADP-5001 Extra Handset CLIPFONE CF220 CLIPFONE CF230 Other - not listed above Colour:  顏色 PIANO WHITE PIANO BLACK MATT BLACK BLUE CERIES CHAMPAGNE GOLD GREY RED SILVER OTHER Serial no. 機身編號 Invoice no. 發票編號 Dealer / Store Name 銷售商號 Purchase price 購買價錢 HK$.00 Date of purchase 購買日期 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 jan feb mar apr may jun jul aug sep oct nov dec 2008 2009 CUSTOMER FEEDBACK 顧客意見 To provide our customers with the best possible products & services, please take a moment to fill out the brief questionnaire below, as your feedback and comments are truly appreciated. 為提高產品質素及服務水準?請回答下列問題﹐多謝您的寶貴意見。 1.  Where will this product be used? 您會在哪裡使用此產品?    Home 家居 Business 公司 2.  Your age group? 您的年齡組別?  <18   18-24   25-34   35-44   >45  3.  Your rating of this product? (1-Very Satisfied, 2-Satisfied, 3-No Comment, 4-Unsatisfied, 5-Very Unsatisfied) 您怎樣評價此產品? (1-非常滿意 2-滿意 3-無意見 4-不滿意 5-非常不滿意) Design 設計   Quality 品質   Price 價格   Built-In features 功能 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 4.  For future models, what features do you want to add to this product? (check all that apply) 您最期望增加的產品功能?(可選多於一個選擇) Handsfree earset 免提耳機   Silent vibrator 震機功能   Back light 夜光鍵盤及顯示   Music on hold 音樂等候   Others (Please specify) 其他(請述)  5.  How did you know about this product? (Check all that apply) 您怎樣認識此產品?(可選多於一個選擇) Recommended by friend 朋友介紹   Sales staff 店員介紹   Product catalogue 產品單張   Trade fairs 展覽會   From newspapers, magazine or Internet (Please specify) 從報章,雜誌或互聯網認識(請述名稱)  6.  Do you want to receive information about our new products? 您是否想通過電郵接收更多新產品資訊? Yes     No 7.  Any comment on our products? 其他意見?