PURCHASER

Name : (required)

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Date of birth : (required)

Address: (required)

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HELMET FEATURES

Model reference: (required)

Color: (required)

Size: (required)
--- XXXS XXS XS S M L XL XXL

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)

1. Why did you choose a PREMIER helmet?

--- Graphics e Design Quality Comfort Advertisement and magazines Recommended by the dealer Brand Safety Competitive price Have you owned a Premier helmet before Recommended by a friend Other

Other:

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

Other:

3. What type of motorcycle do you ride?

11. Help us improve our product with your suggestions!

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