The Quickupcamper (tm) , a patented design from Jay Baldwin Design, has yet to come to market (read more about Jay Baldwin.) Please complete this form to register your interest for the design concept.

The results of this survey will be shared with various RV manufacturers in an effort to stimulate awareness that a market is out here for such a camper. thepickupcamper.com is conducting this survey on behalf of Quickupcamper(tm).

Confidentiality: thepickupcamper.com is not collecting personally identifying information with the exception of an option to provide an email address to be used if you wish to be notified of the survey results and be put on the newletter mailing list of thepickupcamper.com. Your survey responses and demographic information will be summarized for the study. Your email address will not be sold but may be provided to a manufacturer for exclusive rights to promote the Quickupcamper (tm).

Take another look at the Quickupcamper(tm)!

How would you primarily use a camper like the Quickupcamper(tm)?

Camping/Hunting/Fishing

Mobile Office/Shop

Travel/Sightseeing

Long Term on the Road

What type of a pickup do you have? (current plans will only accomodate newer full size long beds similar to a Ford F-150, but may offer the basic shell without some of the amenities for a short bed. )

Full size long bed

Full size short bed

N/A

How well do you feel each of the following attributes describe what you know about the Quickupcamper(tm)?

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Practical
Easy to Operate
Good Lifestyle Fit
Provide Better Mileage
Safe
Stylish
Roomy
Functional

How interested would you be in owning the Quickupcamper(tm)?

Very Interested

Interested

Neutral

Not Interested

How often do you think you would use the Quickupcamper(tm)?

How much would you expect to pay for the Quickupcamper(tm)?

Optional Fill-in Questions

What do you most like about the Quickupcamper(tm)?

What do you least like about the Quickupcamper(tm)?

Demographics Information

The following information is optional but provides useful information in marketing the Quickupcamper(tm).

Age

Race/Ethnicity

Income

Gender

Male

Female

Do you want to receive the survey results and/or receive thepickupcamper.com periodic newsletter?

I would like to receive the survey results

I would like to receive thepickupcamper.com periodic newsletter

Please complete the email address block if you checked either of the above answers.

Help us refine our audience. How did you heard about this survey?

Confidentiality: thepickupcamper.com is not collecting personally identifying information with the exception of an option to provide an email address to be used if you wish to be notified of the survey results and be put on the newletter mailing list of thepickupcamper.com. Your survey responses and demographic information will be summarized for the study. Your email address will not be sold but may be provided to a manufacturer for exclusive rights to promote the Quickupcamper (tm).

Disclaimer: thepickupcamper.com has no financial interest in Quickupcamper(tm), rather appreciates the design and practicality of the unit and wishes to see it come to market.

Indicates Response Required


This form created at http://www.formsite.com/