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Membership Registration 會員登記表
 
1. Personal Information (Fields marked with an asterisk* are required)
    個人資料 (附有 * 為必須填寫的資料)
 
    Title 稱號*  
    Name 姓名*  
    Postal Address
    郵寄通訊地址*
  室 Room/ Flat 層 Floor 座 Block
大廈 Name of Building
街道號數及名稱 No. and Name of Street
地區 District
    Tel 電話*  
    Email 電郵*  
 
2. Date of Purchase 購買日期*   Pick a date
 
3. Product Type 產品類別*  
 
4. Product Dimension 產品尺碼*  
 
5. Name of Store Where You Purchase
    在哪商戶/舖購買*
 
其他,請註明︰Others, please specify
 
6. Registration Code 登記編碼*   (12 digits)
(參照產品包裝內單張 Refer leaflet in product packaging)

 
7. Are you the first time to purchase this kind of air filter? 您是否首次購買此類空氣濾網產品?
     是 Yes
否,請列出您以往選用之空氣濾網產品:(可選擇多項)
      No, please list down which kind of air filter that you used in the past: (May choose more than one)
Filtrete™ 淨呼吸™ 品牌之
一般過濾 Dust Reduction   高效過濾 Micro Allergen Reduction
清新過濾 Odor Reduction   超效能過濾 Ultra Allergen Reduction
其他品牌,請註明 Other Brand, please specify
 
8. From which media/party did you learn about Filtrete™ Room Air Purifier?
      您從哪些途徑獲取淨呼吸空氣清新機的產品資訊?
TV ad 電視廣告 Newspaper/Magazine 報章/雜誌廣告
Internet 互聯網 Information on Product Packaging 產品包裝上的資料
In-store Promoter 店舖推廣員介紹 Referral from Friends & Relatives 親友介紹
Electronic Direct Email 電子郵件 Others, please specify 其他,請註明
 
9.If your answer in last question is "Referral from Friends & Relatives" and he/she is current Filtrete club member, please fill in his/ her membership number here (This column is required to be filled by first time user only)
如上題的答案是"親友介紹",而他是Filtrete Club的會員,請填寫他的會員編號 (只限首次購買的顧客填寫)

To every members who successfully recommended 2 friends or relatives to use Filtrete air cleaning filter, a gift will be presented as our token of gratitude.
每位會員凡成功推薦兩位親友使用Filtrete靜電空氣濾網,可獲紀念品一份
 
10. What were your primary reasons for purchasing this product? 購買原因
    (Please show sequence of importance, 1=most important) (請以重要性排序,1=最重要)
Allergy or Respiratory Problems
      過敏症/呼吸系統問題

  Colds/Flu
      傷風/感冒

Pet Odors
      家中有寵物

  Trying Out of Curiosity
      好奇使用

General Health Concerns
      一般健康原因/關注

  Tobacco/Smoke Odors
      香煙異味

General Home Environment Concerns
      一般家居環境關注

  Satisfy with Product Performance of Trial Pack
      曾使用試用裝,效果滿意

New Born Baby/Child in Household
      有嬰兒/小童在家

  Others, please specify
      其他,請註明
          

 
11. Occupation of purchase decision maker 決定購買者的職業
Housewife 家庭主婦 Student 學生
Retired 退休人士 Technician 技工
Management 行政管理人員 Clerical 文員
Professional 專業人士 Sales 銷售人員
Others, please specify 其他,請註明
 
12. Age of purchase decision maker 決定購買者的年齡
14 or below 歲或以下 15-19 歲
20-24 歲 25-34 歲
35-44 歲 45-54 歲
55-64 歲 65 or above 歲或以上
 
13. Age of child at home? 家中子女的年齡?
      (May choose more than one) (可選擇多項)
No child 沒有子女 3 or below 歲或以下
4-12 歲 13 or above 歲或以上
 
14. Which group describes your monthly household income? 家庭每月總收入為以下那一項?
Under HK$14,999 或以下 HK$15,000 - HK$29,999
HK$30,000 - HK$44,999 HK$45,000 or above 或以上
 
15. How many of the following products are used at home? 家中有多少以下的產品?
      Which have you applied Filtrete™ Air Cleaning Filter on it? 有否使用 Filtrete™ 靜電空氣濾網於其上?
有使用 Applied
冷氣機 Air-conditioner 部 set(s)
空氣清新機 Room Air Purifier 部 set(s)
抽濕機 Dehumidifier 部 set(s)
濾水器 Water Purifier 部 set(s)
 
16. How frequent does the filter have to be replaced? 平均多久需要更換新的 Filtrete™ 靜電空氣濾網?
     月 month(s)
 
17. During which months would you use Filtrete™ Air Cleaning Filter? (May choose more than one)
      您會在哪些月份使用 Filtrete™ 靜電空氣濾網?(可選擇多項)
3-5月 Mar-May 6-8月 Jun-Aug 9-11月 Sep-Nov
12-2月 Dec-Feb 全年 All year round
 
18. Other comments on this product 您對本產品的其他意見

 
The information you provide will be retained in our files and it maybe used for 3M market research studies and allow us to contact you directly regarding product information and privilege promotion. You may opt out of being contacted directly elsewhere on this form. Your feedback will be valuable for us in providing even better quality products and services to fulfill your needs.
閣下填寫的個人資料將保留在我們的客戶資料庫,資料只會用以日後與閣下聯絡,及用作 3M 公司內部市場分析及產品推廣之用。你將有權拒絕任何本公司發出的資訊。閣下提供的資料將進一步協助本公司提升產品及客戶服務質素。
 
I wish to be contact for product information and privilege promotions from 3M.
本人願意接受 3M 公司日後的產品資料及優惠推廣。
I wish 願意 I don't wish 不願意