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NutraMilk Registration Form
This form registers your product and helps us to gain a better understanding of our consumers.
Note that failure to complete and return this form does
not
diminish your warranty rights.
Registrant
First Name
*
Last Name
*
Address 1
*
Address 2
City
*
State
*
Zip
*
Phone
*
Email Address
*
Product Information
Purchased From
*
Model Number
*
Purchase Price
*
Date of Purchase
*
+
Purchase Decision
Please check the most important reasons
influencing your purchase of the NutraMilk:
*
Brand Reputation
Advertised Special
Product on Sale
Salesperson's Recommendation
Friend/Relative's Recommendation
Packaging
Received as a Gift
How did you first learn about the NutraMilk?
*
Word of Mouth
Store Advertisement
Store Display
Magazine Article
Print Advertisement
Other
Other