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.
Mrs.
Ms.
Model: Blender Solution
™
5000
1. Name __________________________________________________________________
2. Address _________________________________________________________________
City ______________________________________ State ______ Zip Code _____
3. E-Mail Address ____________________________________________________________
4. Age: 18-24
25-34
35-49
50+
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+
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 influencing 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 satisfied 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
COMMENTS _______________________________________________________________________
__________________________________________________________________
WARRANTY
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