Please complete and return this product warranty card or register your
product online at: backtobasicsproducts.com within 10 days of purchase.
THIS INFORMATION IS FOR INTERNAL USE ONLY
Mr.
Mr.
Mr.
Mr.
Mr.
Mrs.
Mrs.
Mrs.
Mrs.
Mrs.
1. Name ___________________________________________________________________________
2. Address _________________________________________________________________________
City ______________________________________ State ______ Zip Code ___________
3. E-Mail Address __________________________________________________________________
4. Age:
4. Age:
4. Age:
4. Age:
18-24
18-24
18-24
18-24
5. Marital Status:
5. Marital Status:
5. Marital Status:
6. Number of Children in the House :
7. Income:
7. Income:
7. Income:
7. Income:
7. Income:
Below $25,000
Below $25,000
Below $25,000
Below $25,000
Below $25,000
8. Where was this product purchased? _______________________________________________
9. How did you become aware of this product?
____ Gift
____ TV advertisment
____ Print Ad
____ Magazine article
10. Check the two most important reasons infl uencing your purchasing of this Back to Basics
product:
____ Gift
____ Special offer
____ Product appearance
____ Ease of operation
____ Quality/durrability
____ Product features
11. Why did you purchase this product?
____ Purchased as a replacement/upgrade of broken product
____ Purchased as secondary product in addition to product(s) already
____ First product(s) ever owned
____ Recieved as a gift
12. Would you be interested in being contacted via e-mail for promotions, recipes, new
product information, etc.?
product information, etc.?
product information, etc.?
COMMENT ________________________________________________________________________
___________________________________________________________________________________
WARRANTY
Ms.
Ms.
Ms.
Ms.
Ms.
Miss
Miss
Miss
Miss
Miss
25-34
25-34
25-34
25-34
Married
Married
Married
12 yrs and under _________ 13-18 yrs _________
$25,000-$50,000
$25,000-$50,000
$25,000-$50,000
$25,000-$50,000
$25,000-$50,000
owned
YES
YES
YES
Model: Blender Express
35-49
35-49
35-49
35-49
Single
Single
Single
$50,000-$75,000
$50,000-$75,000
$50,000-$75,000
$50,000-$75,000
$50,000-$75,000
____ Reccomendation from friend
____ Saw product in store
____ TV shopping program
____ Internet
____ Other _________________________
____ Recommended by sales person
____ Recommended by friend
____ Prior expierence with Back to Basics
____ Back to Basics brand reputation
____ Value for price
____ Product packaging
____ Other _________________________
NO
NO
NO
15
™
50+
50+
50+
50+
$75,000+
$75,000+
$75,000+
$75,000+
$75,000+
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