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RRC5980~ I & M ~ TDI's
1.
1.
Please complete the contact information below.
(Required.)
First and Last Name:
Address:
City/Town:
State:
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
Email Address:
Phone Number:
2.
Please supply us with a secondary contact number.
Murray Hill Center standard policy requires at least two contact numbers for each respondent.
If the secondary number you give us is not your own number but a friend, family member or co-worker please indicate as such.
(Required.)
3.
What is your gender?
(Required.)
Male
Female
4.
What is your current age?
(Required.)
5.
What is your ethnicity?
(Required.)
Caucasian
African American / Black
Asian
American Indian / Native American
Hispanic / Latino
Other (please specify)
6.
What is your current work status?
(Required.)
Full-Time Employed
Part-Time Employed
Homemaker
Unemployed / Looking for work
Retired
Student Full-Time
7.
What is your Occupation-Job Title, Company you work for, and Industry?
(If you are Retired, Unemployed or a Homemaker Please tell us your previous employment information. If you are a full-time student please enter your Grade, School and Major)
(Required.)
Occupation:
Company:
Industry:
8.
8. What is the highest level of education that you have completed?
(Required.)
Some High School or less
High School Graduate or GED
Some College - No degree
2 yr College Degree / Associates
4 yr College Degree / Bachelors
Post Graduate Work / Degree
9.
9. What is your current marital status?
(Required.)
Single - Never Married
Single - Divorced
Single - Widowed
Single - Separated
Live with Partner / Co-Hab
Married
10.
what is your total annual income before taxes?
$24K-$34K
$35K-$39K
$40K-$74K
$75K-$100K
$100K-$149K
$150K+
11.
Which of the following trades do you CURRENTLY work in?
General Contractor
Facility / Property Manager
Plumber
Building Engineer
Maintenance, Repairs & Operations
Other
12.
Which of the following is your primary trade ?
General Contractor
Facility / Property Manager
Plumber
Building Engineer
Maintenance, Repairs & Operations
Other
13.
Do you CURRENTLY recommend, install & service any of the following products for your clients, customers, tenants?
Heating & Cooling Systems
Water Heters
Toilets
Faucets
None of the above
14.
Which of the following products are you responsible for your clients, customers, tenants?
Heating & Cooling Systems
Water Heters
Toilets
Faucets
None of the above
15.
What type of water heaters do you install / maintain?
It provides water to the entire property
I provides hot water to just a single sink or shower
16.
Are the worksites / jobsites where you CURRENTLY install water heaters:
Commercial
Residential
Both
17.
How many water heaters has YOUR COMPANY installed in the past 12 months?
18.
Which brands of the following are currently installed of your worksite / jobsite?
HVAC -
Water Heater -
Faucets -
Toilets -
19.
Facility/Property Managers/Engineers & Maintenance, Repairs & Operations:
Do you currently use a Building Management System (BMS) ast the property you manage?
Yes
No
20.
Facility/Property Managers/Engineers & Maintenance, Repairs & Operations:
What is the square footage of the property you currently work in / own?
21.
How many OEM's /Manufacturers are you currently working with?
1 Exclusively
2
3-4
4 or more
22.
How many full time employees does your company have?
1-10
10-50
50-100
100-500
500 +