Thank you for helping us to create a better program by answering this brief Questionnaire! We value your privacy and will not trade, sell or otherwise divulge your personal information.

Upon submission of your completed Questionnaire, you will be entered to win a Free MyGym Fitness System, valued at $279.00!

Good luck and that you for watching Get Fit Hawaii TV!

Contact Information
Name:
Email:
Address
City
State	-- Select One --n/aALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY  Zip
General Information
Are you Male or Female?	Male Female
What is your age?	18 yrs. or Younger 18-24 yrs. 25-34 yrs. 35-44 yrs. 45-54 yrs. 55-64 yrs. 65-70 yrs. 75-80 yrs. 85 yrs. or older No Answer
What is your Occupation?	Professional Managerial Administrative/Supervisory Clerical Medical Legal Technical Sales Manufacturing Worker Educator Entrepreneur Homemaker Student Retired Other
How did you hear about Get Fit Hawaii? (Please check all that apply)	Advertising - TV, newspaper, radio Friends/Family/Someone told me about it Read a magazine article/review Through the internet Poster/flyer/postcard Trade show/convention/exhibition Other (please specify):
How many people in your Household?	1 2 3 4 5 6 7 8 9 10 10+ 20+
Where do you live on most of the year?	Oahu Kauai Big Island Maui Lanai Molokai Mainland US International
What is your yearly household income range (US dollars)?	Less than $16,000 Between $16-24K Between $25-40K Between $41-55K Between $56-75K Between $76-100K Over 100K No Answer
Are you a member of a Health Club?	Yes No
If Yes, which one?
If No, which one would you join?
How often do you watch Get Fit Hawaii on Television?	Every day or almost every day Twice a week Once per week or more often 2 to 3 times per month Once every 2 to 3 months Once or twice a year Never
Do you have Cable/Digital TV or DISH?	Yes No
Do you record Get Fit Hawaii TV for later playback?	Yes No
What time do you usually exercise?	Morning Afternoon Evening Never
What are the main reasons you watch Get Fit Hawaii TV? (Please check all that apply)	Enjoy working out with the team Want to see how MyGym works Cardio Kickboxing Karate Workouts Bootcamp Workouts Want to hear nutritional/health tips Enjoy the views/scenery Enjoy looking at sculpted bodies exercising Use the show for inspiration Other (please specify):
How would you describe your fitness level now?	Totally out of shape OK but needs work Basically good shape Trim and toned Athlete
Do you work out with the crew on the tv in your home?	Yes No
What is your highest level of education?	High School Some College or Trade School Basically good shape Completed College Completed Graduate School or more No Answer
Overall, how do you rate the quality of the Get Fit Hawaii Television Show?	Excellent Very Good Good Fair Poor
Would you recommend Get Fit Hawaii to a friend or associate?	Definately Probably Not Sure Probably Not Definately Not
Would you download the show from the internet if they were free but had commercials?	Yes No
Would you download the show from the internet if they cost 99 cents but had no commercials?	Yes No
Which of these products do you own? (Check all that apply)	Treadmill Stationary Cycle Stair Master Dumb Bells Bands Yoga Mats Bowflex MyGym Fitness System Other (please specify):
How likely are you to buy the MyGym Fitness System in the future?	Very Likely Somewhat Likely Not Sure Somewhat Unlikely Very Unlikely
How satisfied are you with your MyGym Fitness System from Get Fit Hawaii?	Extremely Satisfied Very Satisfied Neutral Unsatisfied
What are your hobbies/intrests? (Please check all that apply)	Antiques/Collectibles Books/Reading Camping/Outdoors Cars Motorcycles Computers Fashion Investing Shopping Politics Travel Pets Gardening Sports/Physical Activity Film/Movies Music Dining Out Cooking Home Improvement Parenting Decorating Crafts Dating/Marriage Arts/Cultural Activities TV/Video/DVD Nutrition/Health Community Education Classes Religion/Spirituality Other (please specify):
What would you best describe yourself as?	Married Committed/Partnered Divorced Widowed Single Other No Answer
What health, sports and fitness activities do you enjoy? (Please check all that apply)	Baseball/Softball Basketball Biking Billiards/Pool Body building Extreme Sports Golf Hiking Hockey Holistic Health Inline Skating Martial Arts Meditation Nutrition Rodeo Rugby Running Sailing/Boating Scuba Diving Skateboarding Skiing Snowboarding Soccer/Football Surfing Swimming Tennis/Racquet Sports Triathlon Walking Weight Training Wrestling Yoga Other (please specify):
Comments
Please write any comments that you may have about Get Fit Hawaii:
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