Lucina Strap Promotion

Lucina Strap Promotion

Thank you for purchasing a Lucina AX-09 Synthesizer. In order to receive your free Roland strap, please complete the survey below. Print and mail the confirmation page along with a copy of your sales receipt and original UPC code from the packaging, and we’ll ship out your free strap.

If you are not already a Backstage member, your Backstage pass will automatically be created. You can use your Backstage pass to:

  • Track your rebate's progress
  • Receive communication if there are any issues fulfilling your rebate
  • Email Product Support if you have questions about using your new product

Select the color strap you would like:

Personal Information
First Name:
Last Name:
Email Address:
Verify Email:
Phone:
( ) -
Address 1:
Address 2:
City:
State:
Zip Code:

Gender:
Male Female
Age Range:
0-18 | 19-24 | 25-34 | 35-44 | 45-54 | 55+
Product Information
Date Purchased:
Serial Number:
Dealer Name:
Dealer City:
Dealer State:

Gear
What is your primary musical instrument?
Keyboards: Piano/Organ/Synth/Arranger/Accordion
Piano
Organ
Synth
Arranger
Accordion
Guitar: Acoustic/Electric
Acoustic Guitar
Electric Guitar
Bass: Acoustic/Electric
Acoustic Bass
Electric Bass
Drums: Acoustic/Electric
Acoustic Drums
Electronic Drums
Other
None
What musical instruments do you currently own? (check all that apply)
Acoustic Piano
Digital Piano
Organ
Synthesizer/Workstation
Arranger Keyboard
Accordion
Acoustic Guitar
Electric Guitar
Acoustic Bass
Electric Bass
Acoustic Drums
Electric Drums
Drum Machine
Other
What other music equipment do you currently own? (check all that apply)
Keyboard Amplifier
Guitar Amplifier
Bass Amplifier
Effects Processors/Pedals
PA System
Studio Monitors
Stereo Recorder
Multi-track Recorder
Macintosh Based Software
Windows Based Software
DAW Control Surface
Audio Interface
MIDI Interface
MIDI Controller Keyboard/Pads
Groovebox
Sampler
Turntable
Virtual Instruments
Other
Activity
What best describes your involvement with music? (check all that apply)
Professional performing musician
Semi-professional performing musician
Hobbyist
Music Student
Worship Musician
DJ/Remixer
Professional recording engineer/producer
Home recording musician
Other
Besides music, what do you enjoy doing in your spare time? (check all that apply)
Theater
Sports
Reading
Video Games
Movies
Concerts
Arts & Crafts
Automobiles
Restaurants
Computers
Other
What kind of computer OS do you use?
Windows® 2000
Windows® XP
Windows® Vista
Windows® 7
Mac OS
Other
None
Purchase
How did you buy?
Physical Storefront
Mail Order/Catalog
Online
Where did you buy?
Music Store
Consumer Electronics Store
Department Store
Audio/Visual Store
Other
Where did you learn about the Lucina?
Roland Website
Other Website
Email Communication
Specialized Magazine (Keyboard, EM...)
General Magazine
Newspaper
Musical Instrument Store
School
Catalog
Friend
Event
Artist Use
TV/Radio
General Ad
Other
What were the reasons for purchasing the Lucina?
Price
Sound & Function
Operation
Design
Credibility of Brand
Shop Recommended
Friend Recommended
School
Brand

Contact me for future Roland surveys.

Would you like to receive any of the following via email? (check all that apply)
Insider: The Roland U.S. bi-monthly email newsletter.
All Access: The BOSS U.S. bi-monthly email newsletter.
Worship Connection: Periodic newsletter for our Worship Arts community.

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