Bowflex Xxtreme 2 SE, Owner'S Manual & Fitness Manual

Page: 89 / 92

IMPORTANT! MAIL WITHIN 0 DAYS OF PURCHASE
PLEASE PRINT CLEARLY – THANK YOU
Bowflex Xtreme
®
2 SE Warranty Registration Card
Please check here if you would prefer not to obtain information on new and interesting opportunities from other exciting companies.
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:
( )
M M
D D
EXT.
M M
D D Y Y
Y Y