Record of Purchase

Record of Purchase Form, Warranty Registration

Dear

The enclosed warranty for our product is as strong and
effective as we can make it.

We would appreciate your returning this record of purchase
so that we will be able to assist you with any questions or
problems in the use of our product. In our desire to
constantly improve our products and service to you, we
request that you answer as many questions as possible.

Thank you.

Please Detach Here
************************************************************

IMPORANT! RECORD OF PURCHASE
Name________________________Date Purchased__________________
Address_____________________________________________________
City_________________State__________________Zip_____________
1.Purchaser_____Man_______Woman________Teenager________Youth
2.Age of users________ __________ _______ _______
3.Name of store where purchased_____________________________
4.Purchased for________Gift_________Personal Use
5.Price paid $_________
6.Would you recommend this product to others?_______________
7.Comments:_________________________________________________
__________________________________________________________