Your Helmet...

1. Helmet specifics:

   Brand
   Model
   Date of Manufacture



2. Head/Helmet Size (check one)
   
Less Than 6 1/2
6 1/2 - 7
7- 7 1/2
7 1/2 - 8
8 or Greater
Other


3. Helmet Color No Response Black White Red Green Blue Yellow Purple Orange Multi Other
   Other Color
   
 
4. None B-90 B-95 E2001 H-84 H2000 K-98 K2005 M-90 M-95 M2000 M2005 N-94 RS-98 S-98 SA-90 SA-95 SA2000 SA2005 Snell Sticker
   
   

5. Other Certifications (check all that apply) 
   ANSI Z90.4
   ASTM F1447
   CPSC
   EC (European)
   CSA (Canadian)
   BSI (British)
   TUV (German)
   SEI
   Other
   
   

6. Where did you buy this helmet? (check one)
   
Catalog
Department Store (Sears,etc..)
Mass Market (Wal-Mart, Target, K-Mart, etc..)
Specialty Store (Sports Authority, REI, local dealer, etc..)
Internet/Online
Other


7. How long ago did you purchase this helmet? (check one)
   
Less than 1 year
1 to 3 years
3 to 5 years
5 to 10 years
More than 10 years
Other


8. How often do you use a helmet when you ride? (check one)
   
Always
Frequently - 4 times out of 5
Some times - half of the time
Seldom - 1 time in 5
Never
 
 

Your Opinions...

1. Why did you buy this helmet? (check all that apply)
   
Safety
Style
Sales Person
Parents/Friends
Cost
Mandatory Use
 
2. How do you wear the chin strap adjustment? (check one)
   
Secure
One finger gap
Loose
Slop
Undone
 
3. How do you rate your helmet? (check one for each catagory)

Style	Comfort	Fit	Overall
Great	Great	Great	Great
Good	Good	Good	Good
Fair	Fair	Fair	Fair
Poor	Poor	Poor	Poor
Awful	Awful	Awful	Awful

Background Information (optional)...

Age  Your age less than 1515 to 2021 to 3031 to 4041 to 5051 to 6061 to 70over 70 years

Are You..  Male Female

Privacy Notice:     The Snell Memorial Foundation will not share any specific information with anyone.  All information collected is used for statistical  analysis only.