Cafe Valencia - product registration

Thank you for purchasing a CaféValencia® product. By “Submitting” this “Product Registration Card” we can confirm the date of purchase for your product. This confirmation is of benefit to you, especially if youroriginal proof of purchase is lost.

**Product Registration Card**
Mr. Mrs. Ms. Miss.
First Name Initial Last Name
Street	Apt. No
City	State	ZIP Code
E-mail Address

Date of Birth Month Year
Marital status Married Single
Telephone Number
Model Number
Serial Number You can find your serial number on the top right corner of your original Product Registration Card.
Name of store where purchased
Price Paid (Excluding sales tax)
What type of purchase was this? Received as a gift Replacing a product First time purchase of this product Additional product purchase
What factor most influenced your decision to purchase this Cafe Valencia product? (Check all that apply) Received as a gift Brand name Advertisement Store circular Product style/Pattern/Color Style Size Price Product was on sale Product Features Product Durability In-store display Other
How important were each of the following in your decision to purchase our product? Performance Important Unimportant Price Important Unimportant Value Important Unimportant Warranty & Service Important Unimportant High Quality Important Unimportant Name Brand Important Unimportant Shopping Convenience Important Unimportant
If you received as a gift, what was the occasion? Wedding gift Anniversary Holiday Mother's day Birthday Other
How often will you use this product? More than three time a week Once or Twice a week Once or twice a month Once or twice a year
What type of cuisine does your household prepare most often? Traditional American Asian Middle East Low Fat/Healthy Vegetarian Caribbean Mexican/Southwestern Italian Other

Please check all that apply to your household Shop via catalog/mail Shop via the internet Member of frequent Flyer program Donate to charitable causes Own a CD or DVD player Have a dog Have a cat Own a wireless/cellular phone Subscribe to an online/internet service Speak Spanish Own PC
Not Including yourself, what is the GENDER and AGE (in years) of the children and other adults living in your household? No one else in household Child under 1 year Male Female Age Male Female Age Male Female Age Male Female Age
Whitch Whitch group describes your annual family income? Below $ 20,000 $ 20,000-29,999 $ 30,000-39,999 $ 40,000-49,999 $ 50,000-74,999 $ 75,000-99,999 $ 100,000-149,999 $ 150,000 +
Level of education: (Check highest level completed) Completed High School Completed College Completed Graduate School
Which credit cards do you use regularly? American Express, Diners Club Master Card, Visa, Discover Department Store, Oil Company, etc Do not use credit cards
For your Primary residence, do you: Own? Rent?
Which of the following do you plan to do within the next 6 or 12 months? Buy/Lease a new vehicle 1-6 months 1-7 months
Buy/Lease an used vehicle 1-6 months 1-7 months

Thank you for taking the time to fill out this questionnaire. Your answers will be used for market research studies and reports. They will also allow you to receive important mailing and special offers from a numbers of fine companies whose products and services related directly to the specific interests, hobbies, and other information indicated above. Through this selective program, you will to able to obtain more information about activities in which you are involved and less about those in which you are not.

"We welcome your comments please send us feedback"