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IMPORTANT! MAIL WITHIN 30 DAYS OF PURCHASE
PLEASE PRINT CLEARLY – THANK YOU
Bowflex
®
SelectTech
®
5.1 Bench Warranty Registration Card
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Thanks for filling out this questionnaire. Your answers are important to us.
Mr. 2. Mrs. 3. Ms. 4. Miss Customer ID from Invoice:
Name:
Address: Apt. #:
City: State: Zip:
Phone number: -
E-Mail address:
Is this your primary address? Yes No
Place of purchase:
Date of purchase:
Purchaser date of birth:
Gender: Male Female
Marital status: Married Single
Including yourself, total number of people living in your household: (Examples: 01, 02, 03 …)
Would you like to receive additional information on healthy lifestyle products? Yes No
Which best describes your family income: (US dollar figures)
Under $15,000 $25,000 – $34,999 $50,000 – $74,999 $100,000 – $149,999
$15,000 – $24,999 $35,000 – $49,999 $75,000 – $99,999 Over $150,000
What other types of exercise equipment do you own?
Did you receive this item as a gift? Yes No
Name of original purchaser:
Original purchaser customer ID number:
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D D
EXT.
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D D Y Y
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