2 years

PURCHASER

Name and Surname : (required)

Address: (required)

City: (required)

Zip code: (required)

State: (required)

Email: (required)



HELMET FEATURES


Model reference: (required)

Color: (required)

Size: (required)

Homologation Number: (required)
(Es: E3012345/P 012345) The number is on the ticket sewn to your chin-strap



INFORMATION ON THE PURCHASE


Date of purchase: (required)

Store/dealer: (required)

Invoice Number/Ticket Receipt Number: (required)

Amount paid for the helmet: (required)



WHERE DID YOU BUY THE HELMET


Name of the dealer:

Address:

City:

Zip Code:



1. Why did you choose a PREMIER helmet?

Other:


2. What helmet did you use before purchasing a PREMIER helmet?

Other:


3. What type of motorcycle do you ride?



4. What motorcycle magazines do you regularly read?

Other:


5. What motorcycle web site do you regularly follow?


6. What Social network site do you regularly follow?

Other:


7. How old are you?



8. Gender?



9. What are you currently doing?

Other:


10. For how many years have you used your helmet before buying a new PREMIER helmet?

Years:
Months:

11. Help us improve our product with your suggestions!




Conforming to the Italian law n. 196 of Giune 30th 2003, I hereby explicity authorise the use of my personal data. (Civil Code for the Protection of Personal Privacy)

I authorize:

I do not authorize: