Bowflex
PLEASE PRINT CLEARLY – THANK YOU
1.
■
Mr.
2.
■
Mrs.
Name:
Address:
City:
Phone number:
E-Mail address:
Is this your primary address?
Place of purchase:
Date of purchase:
Purchaser date of birth:
Gender:
■
Male
■
Female
Marital status:
■
Married
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?
Which best describes your family income:
■
Under $15,000
■
$15,000 – $24,999
What other types of exercise equipment do you own?
Did you receive this item as a gift?
Name of original purchaser:
Original purchaser customer ID number:
Thanks for filling out this questionnaire. Your answers are important to us. Please check here
not to obtain information on new and interesting opportunities from other exciting companies.
® 2005. Nautilus, Inc. All Rights Reserved. Bowflex and TreadClimber are registered trademarks of Nautilus, Inc.
®
TreadClimber
IMPORTANT! MAIL WITHIN 30 DAYS OF PURCHASE
3.
■
Ms.
4.
■
Miss
–
■
Yes
■
No
■
Single
■
$25,000 – $34,999
■
$35,000 – $49,999
■
Yes
■
No
®
Warranty Registration Card
Customer ID from Invoice
■
■
$50,000 – $74,999
■
$75,000 – $99,999
Apt. #:
State:
Zip:
Yes
■
No
■
$100,000 – $149,999
■
Over $150,000
■
if you would prefer