Warranty Registration Form

This form registers your product and helps us to gain a better understanding of our consumers.

Note that failure to complete and return this form does not diminish your warranty rights.

Registrant

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Phone *

Email Address *

Product Information

Model Number *

Serial Number *

Store Name *

Purchase Price *

Date of Purchase * +

Additional Offers: *

Do you wish to receive offers or product updates via email?

Do you wish to obtain information or opportunities from other companies via email?

Please check the most important reasons
influencing your purchase of this product: *

How did you first learn about this product? *

What other brands did you consider before selecting this product? *

Year of Birth

Your gender

Male

Female

Your marital Status

Married

Single

For your primary
residence, do you:

Own

Rent

Which best describes
your family income?

Education:

Someone in my home participates in the following activities (check all that apply):

Automotive work	Bible/devotional	Boating/sailing
Camping/hiking	Casino gambling	Contribute to charitable causes
Crafts	Cultural art/events	Cycling
Do-it-yourself	Enter sweepstakes/contests	Fishing
Fitness/exercise/jogging	Gardening	Golf
Gourmet cooking/food/wines	Grandchildren	Home decorating
Hunting/Shooting	Investments (mutual funds, IRA's)	Investments (stocks & bonds)
Movie watching	Own a cat	Own a dog
Snow skiing	Self improvement	Soccer
Tennis	Travel - Foreign	Travel - U.S.
TV shopping	Vitamins/natural foods	Watch sports on TV