B-Class F-CELL Questionnaire

The Mercedes-Benz B-Class F-CELL is the first Zero Emission Mercedes-Benz vehicle available to customers. A small number of the electric cars, powered by hydrogen fuel cells are now available in both Northern and Southern California. These cars emit only water, have a driving range of about 240 miles and can be refueled within 3 minutes. A small number of customers will be given the opportunity to lease these cars in limited areas of California, near Los Angeles and the San Francisco Bay area. If you are interested in being considered, please fill out this survey. Perhaps you'll be among the first to lease a Mercedes-Benz F-CELL.

Personal details		Business details

First name*		Company
Last name*		Address
Address*		Address 2
City*		City
State*		State
Zip Code*		Zip Code
Phone Number*		Phone Number
Email Address*		Email Address
Gender, Age*