WINDCHASER - CUSTOMER SERVICE

Prompt product registration confirms your right to the protection available under the terms
and conditions of your WindChaser Products, Inc. Warranty.

Customer Name:

Suffix	First	M	Last

Address:

City:

State/Province:

Country:

Postal Code:

Phone Number:

( ) -

Email Address:

Model Number:

Model Name:

UPC #:

(Last 6 digits of UPC barcode located on product cartoon)

662571 - *

Date of Purchase:

Purchase Price:

$ .00

Store Name:

How did you first become aware of this Product?

Check the two most important reasons influencing this purchase.

Received as a Gift	Family/Friend
Quality/Durability	Improve wellbeing
Appearance/Style	Value for Price
WindChaser's Name	Warranty/Service
Store Salesperson	Advertisement
Recommended by Dr.	In-Store Display

If you received this product as a gift, what was the occasion?:

How often do you anticipate using this product?:

Do you currently own any other WindChaser Products?:

What is your date of birth?:

What is your marital status?:

Including yourself what is the total number of people living in your hosehold?:

Education:

For your primary residence, do you:

Which best describes your family income?:

Comments / Questions:

Press the Submit button to process this registration
or press the Reset button to clear all the answers.

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