Your name

Your address

Tel no.

Email Address

Are you? male female

Are you a diver?
yes no
If yes, which agency
PADI BSAC SAA IANTD Other

Are you a member of a dive club?
yes no

Do you dive in the UK?
yes no

How old are you?
under 20 20-24 25-29 30-34 35-39 40-44 45+

How many holidays do you take per year?
1 2 3 4+

Approximately how many dives do you make per year (UK or abroad)?
none 1-9 10-19 20-29 30 plus

Which of the following do you own?
Mask Fins Cylinder BC
Regulator Wetsuit Drysuit Weightbelt None

Which of the following are you planning to buy in the next year?
Mask Fins Cylinder BC
Regulator Wetsuit Drysuit Weightbelt None

Are you?
a student self-employed employed parttime employed fulltime unemployed caring for children/dependants

Would you consider using the internet to buy products?
yes no
or book holidays yes no
or buy services like insurance yes no

Thanks & Good Luck!!