1. How did you hear about Kasco?

Magazine Word of Mouth Existing Customer Catalog Mailer Trade Show Website *

Which one, which distributor, or from whom?

*

2. What Kasco Products are would you like more information about?

(Press and Hold Ctrl and Click on the selections; more than 1 can be selected)

3. Pond Length (In Feet)

4. Pond Width (In Feet)

5. Average Depth (In Feet)

6. Maximum Depth (In Feet)

7. Which option below most closely represents the shape of your pond?

8. What Benefits of a Fountain, Aerator, Circulator, Lights, and/or Bacteria are important to you?

Aeration

Aesthetics (Fountain Pattern)

Improved Water Quality

Improved Water Movement

9. Is the pond used for fishing?

10. Is power available at the ponds edge?

11. If so, what type (Voltage, phase, and Hz?

12. Does the pond get a constant supply of water?

Yes No

13. If so, at what GPM (Gallons Per Minute) if known?

14. Would you consider lights for the Fountain?

15. What is the ponds purpose?

(Press and Hold Ctrl and Click on the selections; more than 1 can be selected)

Decorative, Water Retention, Irrigation, Recreation, Fishing, Raising Fish,

Other:

16. How old is your pond?

17. What, if any, treatments are being used for algae or weed control?

Comments:

Your Name

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Company Name

Mailing Address

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City

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State

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Country

Daytime Phone

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Evening Phone

Zip

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Email Address

*