Lieberfarb - Wedding Rings And Engagement Rings

We are happy to answer any questions or listen to any comments you may have. In order to understand who our customers are, we are asking you to fill out the following short form. Thank you for choosing Lieberfarb.

* Fields marked with an ( * ) are required.

First Name*

Last Name*

Street Address

Apartment No.

City*

State*

Zip Code*

Province

Country

Email address*

Please re-enter email address

Please enter your nearest city?*

Are you a retail store? Yes No

JBT ID#:

How did you discover our web site?*	An Article Mentioning Us Another Web Site Search Engine
	Word Of Mouth Magazine or Newspaper Ad
	Jeweler/Jewelry Store A Friend Other Other:

On which web site(s) did you find us?*

TheKnot.com WeddingChannel.com Other

Other:

On which search engine(s) did you find us?*	Alta Vista AOL AllTheWeb Ask Jeeves Dogpile
	Excite Google HotBot IWon Lycos MSN
	Netscape Yahoo! Other Other:

In which magazine(s) did you find us?*	Bridal Guide Elegant Bride In Style Weddings
	The Knot Wedding Dresses Other Other:


Question or Comment* (Please note that Lieberfarb does not sell direct to the public. Therefore, for price information, contact your local fine retail jewelry store.)