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SCOTT FLY ROD Product Registration Form

* Indicates Required Field
  If not applicable enter None  

Model:*  Serial #:* Date Purchased:*
Purchased From (Dealers Name)*
                        CITY:* STATE:*

YOUR FIRST NAME:* 
 YOUR LAST NAME:* 
        ADDRESS:* 
           CITY:*  STATE:*  ZIP:*
        COUNTRY:*  
          EMAIL:  
      TELEPHONE:  
            FAX:  

    
Age Group  M      F
10-17   18-24  25-34   35-44   45-54  55-64  65-74 Over 75

How did you learn about Scott Fly Rods?
Magazine           Dealer
Internet           Tradeshow
Television         Scott Pro Staff or Guide 

Income Range
$0-$20,000         $20,000-$40,000    $40,000-$60,000
$60,000-$80,000    $80,000-$100,000   $100,000-$150,000
$150,000-$200,000  $200,000+

Number of days per year you fish
0-5 6-15 16-30 31-50 50+

Do you
Fly fish only Fly fish and bait/lure fish

Major influence for purchasing a Scott Fly Rod
Dealer                Another fisherman/friend
Advertisement         Catalog
Sports show           Guide/Professional
Fly Fishing School    Scott customer service
Own other Scott rods  Scott Web Site
    
Three most important features considering in buying a rod
Rod action            Quality of components
Cosmetics             Price
Physical Lightness    Warranty

How did you purchase your Scott Rod?
Retail Store          Flyfishing Catalog

Number of years fly fishing?
0-2   3-6   7-10   11-20   21+

How would you rate your fly fishing skills?
Beginner        Advanced Beginner
Intermediate    Advanced Intermediate
Expert          Professional Guide

Check the publications you subscribe to or read regularly
American Angler           Saltwater Fly Fishing
Fly Fishing in Saltwaters Fly Rod & Reel
Fly Fisherman             Field & Stream
Warmwater Fly fishing     Midwest Fly Fishing
Wild Steelhead & Salmon   Atlantic Salmon Journal
On The Water              Mid Atlantic Flyfising Guide
California Fly Fishing    Fly Fishing
Outdoor Life              Outside
Sports Afield             Men's Journal
Other                     Trout
Please List:


I fly fish for (you may check more than one)
Trout      Largemouth Bass    Tarpon     Striped Bass
Panfish    Smallmouth Bass    Seatrout   Bluewater species
Bonefish   Salmon/Steelhead   Redfish

Do you 
Wade fish        Float tube
Own a driftboat  Own a saltwater boat

How many guided fly fishing trips do you take per year? 

How many fly rods do you own? 

How many more fly rods do you plan to buy?  

What other brands of fly rods do you own?   

What other Scott fly rods do you own?       

Are you familiar with Scott's line of accessories? Y N

How can we improve Scott products?