Back to Basics Cocoa-Latte Express CLEX100, User Manual

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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
WARRANTY
Mr. Mrs. Ms. Mr. Mrs. Ms. Mr. Mrs. Ms. Mr. Mrs. Ms. Model: Cocoa~Latte Express
™
1. Name __________________________________________________________________
2. Address _________________________________________________________________
City ______________________________________ State ______ Zip Code _____
3. E-Mail Address ____________________________________________________________
4. Age: 18-24 25-34 35-49 50+ 4. Age: 18-24 25-34 35-49 50+ 4. Age: 18-24 25-34 35-49 50+ 4. Age: 18-24 25-34 35-49 50+ 4. Age: 18-24 25-34 35-49 50+
5. Marital Status: Married Single 5. Marital Status: Married Single 5. Marital Status: Married Single
6. Number of Children in the House : 12 yrs and under _________ 13-18 yrs _________
7. Income: Below $25,000 $25,001-$50,000 $50,001-$75,000 $75,001+ 7. Income: Below $25,000 $25,001-$50,000 $50,001-$75,000 $75,001+ 7. Income: Below $25,000 $25,001-$50,000 $50,001-$75,000 $75,001+ 7. Income: Below $25,000 $25,001-$50,000 $50,001-$75,000 $75,001+ 7. Income: Below $25,000 $25,001-$50,000 $50,001-$75,000 $75,001+
8. Where was this product purchased? ___________________________________________
9. How did you become aware of this product?
____ Gift ____ Recommendation from friend
____ TV advertisement ____ Saw product in store
____ Print ad ____ TV shopping program
____ Magazine article ____ Internet
____ Other ________________________
10. What were the two most important reasons infl uencing your purchase:
____ Gift ____ Recommended by sales person
____ Special offer ____ Recommended by friend
____ Product appearance ____ Prior experience with Back to Basics
____ Ease of operation ____ Back to Basics brand reputation
____ Quality/durability ____ Value for price
____ Product features ____ Product packaging
____ Other ________________________
11. Why did you purchase this Back to Basics product?
____ To replacement/upgrade current product
____ Not satisfi ed with current product(s) already owned
____ First product(s) ever owned
____ Received as a gift
12. Would you be interested in being contacted via e-mail for promotions, recipes, new
product information, etc.? YES NO product information, etc.? YES NO product information, etc.? YES NO
COMMENTS _______________________________________________________________________
__________________________________________________________________