1. Name & Address:  
    

   * Title Mr.    Mrs.    Ms.    Miss
   * First Name	Initial	* Last Name
   * Street	Apt. No.	* City
   * State/Province	* Zip/Postal Code
   Alabama (AL) Alaska (AK) Alberta (AB) American Samoa (AS) Arizona (AZ) Arkansas (AR) Armed Forces AA Armed Forces AE Armed Forces AP British Columbia (BC) California (CA) Colorado (CO) Connecticut (CT) Delaware (DE) District of Columbia (DC) Micronesia-FSM (FM) Florida (FL) Georgia (GA) Guam (GU) Hawaii (HI) Idaho (ID) Illinois (IL) Indiana (IN) Iowa (IA) Kansas (KS) Kentucky (KY) Louisiana (LA) Maine (ME) Manitoba (MB) Marshall Islands (MH) Maryland (MD) Massachusetts (MA) Michigan (MI) Minnesota (MN) Mississippi (MS) Missouri (MO) Montana (MT) Nebraska (NE) Nevada (NV) New Brunswick (NB) New Hampshire (NH) New Jersey (NJ) New Mexico (NM) New York (NY) Newfoundland (NL) North Carolina (NC) North Dakota (ND) Northern Mariana Is. (MP) Northwest Territories (NT) Nova Scotia (NS) Nunavut (NU) Ohio (OH) Oklahoma (OK) Ontario (ON) Oregon (OR) Palau (PW) Pennsylvania (PA) Prince Edward Island (PE) Puerto Rico (PR) Quebec (QC) Rhode Island (RI) Saskatchewan (SK) South Carolina (SC) South Dakota (SD) Tennessee (TN) Texas (TX) Utah (UT) Vermont (VT) Virgin Islands (VI) Virginia (VA) Washington (WA) West Virginia (WV) Wisconsin (WI) Wyoming (WY) Yukon (YT) Non-U.S./Non-Canadian International
   * E-mail Address
   * Country

    
2. Your date of birth: Month January February March April May June July August September October November December Year 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
    
3. Date of purchase:  Month January February March April May June July August September October November December Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2001 2002 2003 2004 2005 2006 2007 2008
      
4. Which MSD product did you purchase?
    

   MSD product:		Price:
   MSD 6A Ignition		$
   MSD 6AL Ignition		$
   MSD 6T Ignition		$
   MSD 6 Off Road Ignition		$
   MSD SCI Ignition		$
   MSD Digital SCI Ignition		$
   MSD 7AL-2		$
   7AL-3 Ignition		$
   Digital 6-Plus Ignition		$
   Digital 7 Ignition		$
   MSD DIS-2 / DIS-2 Plus Ignition		$
   MSD DIS-4 / DIS-4 Plus Ignition		$
   MSD Ignition Control, all other models		$
   APS Alternator, all models		$
   Pro Billet Distributor, PN85551 / 85561		$
   Pro Billet Distributor, all other models		$
   Timing Control, all models		$
   Heli-Core Plug Wires		$
   Super Conductor Plug Wires		$
   MSD Coil, all models		$
   Other MSD product		$

    
5. Where was this product purchased?
    

   Affiliated parts store (Carquest, NAPA) Independent auto parts store Auto chain store (Autozone, Pepboys, etc.) Wal-Mart, Kmart, Target, etc. Performance speed shop Mail Order Ad or Catalog Repair/Service Center Customizing/Restoration Specialist

   Tire dealership 4-WD specialist Vendor/motorsport event Truck accessory store RV specialist Marine dealer Received as a gift Other

    
6. What type of vehicle will this product be used in?
    

   Drag Race Car Oval Track Car Off-Road Race Vehicle Hi-Performance Street Car Street Rod

   Custom Rod Daily Driven Car Daily Driven Truck Daily Driven S.U.V. Other

    
7. In what vehicle will this product be used?
   
   Year 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Make: Model:

8. What factors most influenced this purchase? (check up to 3)
    

   MSD reputation Experience w/MSD Experience w/Dealer Price Compatibility w/Vehicle Ease of installation Warranty Product's spec. feature

   Immediate availability Saw on another vehicle Endorsed by professional racer Friend's recommendation Salesperson's recommendation Product's claimed benefits American manufacturer Other:

     
9. What other brands did you seriously consider before making this purchase? (check all that apply)
    

   None, only wanted MSD Accel Crane Jacob's Electronics Holley Mallory

   Moroso Vertex Nology Performance Distributors Electromotive Other:

    
10. Which of the following publications do you read regularly? (check all that apply)
     

    4 Wheel & Off Road 5.0 Mustang Car Craft Chevy High Performance Circle Track Drag Racer Dusty Times Fastrack Four Wheeler Hot Boat Hot Rod IHRA Drag Review Import Tuner Motor Home Motor Trend Muscle Mustangs Mustang & Fords

    NHRA National Dragster National Speed Sport News NSRA Street Scene Off Road Popular Hot Rodding Rod & Custom Speedway Illustrated Sport Compact Car Sport Truck Stock Car Racing Street Rodder Super Chevy Super Rod Super Street Trailer Life Truckin' Turbo & High Tech Performance

    
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