(*) Name / Nome / Name / Nom (*) Surname / Cognome / Vorname / Prénom (*) E-Mail Date of birth / anno di nascita / Jahr / An (*) Address / Indirizzo / Adresse / Adresse (*) City / Città / Stadt / Ville (*) Zip Code / CAP / Zip Kode Code postal (*) Country / Nazione / Land / Ètat AFGHANISTAN ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA & BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA-HERZEGOVINA BOTSWANA BOUVET ISLAND BRAZIL BRITISH INDIAN OCEAN TERRITORY BRITISH VIRGIN ISLANDS BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURMA BURUNDI CAMEROON CANADA CANTON AND ENDERBURY IS. CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REP. CHAD CHILE CHINA CHRISTMAS ISLAND COCOS (KEELING) ISLAND COLOMBIA COMOROS CONGO COOK ISLANDS COSTA RICA CROATIA CUBA CYPRUS CZECH REPUBLIC CZECHOSLOVAKIA DEMOCRATIC KAMPUCHEA DEMOCRATIC YEMEN DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC DRONNING MAUD ISLAND EAST TIMOR ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ESTONIA ETHIOPIA FAEROE ISLANDS FALKLAND ISLANDS-MALVINAS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERR GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADALOUPE GUAM GUATEMALA GUINEA GUINEA-BISSAU GUYANA HAITI HEARD AND MCDONALD IS. HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JOHNSTON ISLAND JORDAN KAZAKHSTAN KENYA KIRIBATI KUWAIT KYRGYZSTAN LAOS LATVIA LEBANON LESOTHO LIBERIA LIBYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAU MACEDONIA MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARTINIQUE MAURITANIA MAURITIUS MEXICO MIDWAY ISLANDS MOLDOVA MONACO MONGOLIA MONTSERRAT MOROCCO MOZAMBIQUE NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES NEUTRAL ZONE NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTH KOREA NORWAY OMAN PACIFIC IS. TRUST TERR. PAKISTAN PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN ISLANDS POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIA RWANDA SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH KOREA SPAIN SRI LANKA ST. HELENA ST. KITTS-NEVIS-ANGUILLA ST. LUCIA ST. PIERRE ET MIQUELON ST. VINCENT AND THE GRENADINES SUDAN SURINAME SVALBARD & JAN MAYEN IS. SWAZILAND SWEDEN SWITZERLAND SYRIA TAIWAN TAJIKISTAN TANZANIA THAILAND TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS IS. TUVALU U.S. PACIFIC ISLANDS U.S. VIRGIN ISLANDS UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM URUGUAY USA UZBEKISTAN VANUATU VATICAN CITY STATE VENEZUELA VIETNAM WAKE ISLAND WALLIS AND FUTUNA IS. WESTERN SAHARA YEMEN ARAB REPUBLIC YUGOSLAVIA ZAIRE ZAMBIA ZIMBABWE How munch do you ride per week? < 25 Km 26/75 Km > 76 Km What type of riding do you do? road off-road multisport What other brand do you consider? What other brand bicycle do you/did you own? What magazines do you read more than three-times a year? (*) Model of bicycle purchased (*) Date of purchase (*) Serial number (*) Dealer name (*) Dealer address How important were each of these factors in selecting your bicycle? Components Appearance/color Quality [select] Less important Important Vital [select] Less important Important Vital [select] Less important Important Vital recommendation comfort/ride salesperson help [select] Less important Important Vital [select] Less important Important Vital [select] Less important Important Vital performance brand reputation price [select] Less important Important Vital [select] Less important Important Vital [select] Less important Important Vital value for the money     [select] Less important Important Vital     To send your message is necessary to read and approve the privacy statement. Read. I accept    I do not accept    INTERNATIONAL WARRANTY - Lee Cougan bicycle are warranted to be free of defects in material and workmanship for 3 years from date of purchase. Lee Cougan does not warrant components assembled on the bikes but will act as mediator to assure the quickest possible solution to the problem when asked. A copy of Lee Cougan warranty terms and condition is attached to each bike and frame. - Le biciclette Lee Cougan sono garantite prive di difetti nei materiali e nella costruzione per la durata di 3 anni dalla data di acquisto. Lee Cougan non garantisce i componenti assemblati sulle biciclette ma si costituisce mediatore fra le parti in causa per assicurare che il problema venga risolto nel minor tempo possibile. - Lee Cougan Fahrräder werden gegen Herstellungs- und Material- Defekt für 3 Jahre nach Verkaufsdatum garantiert. Lee Cougan garantiert die auf die Fahrräder montierten Teile nicht, tritt jedoch als Vermittler auf, um für die schnellstmögliche Lösung eventuell auftretender Probleme zu sorgen. - Les vélos Lee Cougan sont garanties contre défauts de fabrication et du matériau pendant 3 ans aprés la date de vente. Lee Cougan ne repond pas pur les composants montés sur les vélos, mais fera l'intermédiaire pour resoudre le plus vite possible des problémes éventuels.

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