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Bowflex®Xtreme 2." HomeGymWarrantyRegistrationCard
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PLEASE PRINTCLEARLY - THANKYOU
3. [] Ms.
[] Mr.
2. [] Mrs.
Name:
Address: I
City:
Phonenumber:
E-Mail address:
4. [] Miss
Customer ID from Invoice I
I-I
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Apt. #: I
State: _
Zip: I
Is this your primary address? [] Yes [] No
Placeof purchase:
Date of purchase:
MM
Purchaserdate of birth:
Gender:[] Male [] Female
D D
YY
MM
D D
YY
Marital status:
[] Married [] Single
Including yourself, total number of people living in your household:(Examples:01,02, 03 ...)
Wouldyou like to receive additional information on healthy lifestyle products?[] Yes [] No
Which best describesyour family income:
[] Under$15,000
[] $25,000- $34,999
[] $50,000- $74,999
[] $15,000- $24,999
[] $35,000- $49,999
[] $75,000- $99,999
[] $100,000- $149,999
[] Over$150,000
What other types of exercise equipment do you own?
Didyou receive this item as a gift? [] Yes [] No
Nameof original purchaser:
Original purchaser customer ID number:
Thanks
for filling out this questionnaire.
Y_)ur answers are important
to us. Please check here [] if you would prefer
not to obtain information
on new and interesting
opportunities
from other exciting companies.
© 2004, The Nautilus Group,
Inc. 1400 N.E. 136th Ave., Vancouver,
WA 98684.
Bowflex,
Nautilus and the Bowflex
and Nautilus Iogos are registered
trademarks
of Nautilus Inc.
)
11673 BX2 (03/2004
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