TEST PROTOCOL

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Test Protocol

Please note that all fields followed by an asterisk must be filled in.

First Name*
First Name*

Last Name

E-mail Address*
E-mail Address*

Web Site URL

Street Address

City

State/Prov*
State/Prov*

Zip/Postal Code

Country*
Country*

Home Phone

Business Phone

Fax

Manufacturer of Test Vehicle*
Manufacturer of Test Vehicle*

Indicate whether:*
Indicate whether:*

If you indicated 'Other' , please provide details:

What type of engine?*
What type of engine?*

	Diesel
	Gasoline

Current # KM / Miles / hours on the engine*
Current # KM / Miles / hours on the engine*

# of KM or Miles between oil changes:*
# of KM or Miles between oil changes:*

Indicate *
Indicate *

	A Kilometers
	B Miles

What Grade of Oil Used?*
What Grade of Oil Used?*

Name of oil manufacturer:*
Name of oil manufacturer:*

Who is your gasoline and diesel fuel supplier?*
Who is your gasoline and diesel fuel supplier?*

# KM/Miles driven /day /week*
# KM/Miles driven /day /week*

Type of Driving*
Type of Driving*

How much idling time between stops*
How much idling time between stops*

Do you use any additives now or ever during the year?*
Do you use any additives now or ever during the year?*

Do you:*
Do you:*

	A Own
	B Lease to Own

What does your maintenance schedule look like?*
What does your maintenance schedule look like?*

	A We perform maintenance regularly
	B We only perform maintenance if a problem emerges

Please enter the word that you see below.

The information supplied will be held in the strictest confidence.