Publicidad
First Name
!!!!!!!!!!!!
Company Name
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Address
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
City
!!!!!!!!!!!!!!!!!!!!!!!
Telephone Number
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Fax Number
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Store Where Purchased
!!!!!!!!!!!!!!!!!!!! !! !! !!!!
E-Mail Address
!!!!!!!!!!!!!!!!!!!!!!!!!!
1. How did you first become aware of this Brother product?
(Please Write in ONE Choice in the box to the left)
A.
Magazine Advertisement
!
B.
Newspaper
C.
TV Advertisement
D.
Radio Advertisement
E.
Brother Website / Internet
2. What other Brother products do you own or have you purchased
in the past?
(Please Write in top 3 choices in the boxes to the left)
!!!
A.
Embroidery Machine
B.
Fax Machine
C.
Label Maker
D.
Laminator
E.
Multifunction
3. Which of the following factors influenced your decision
to buy this product?
(Please Write in top 3 choices in the boxes to the left)
A.
Advertisement
!!!
B.
Brother's Reputation
C.
Ease of Use
D.
Features
E.
Friend / Relative
F.
Price / Value
4. Please Select the Primary use for this product?
(Please Write in ONE Choice in the box to the left)
Business Use ( 1 - 5 Employees)
A.
!
( 6 - 19 Employees)
B.
( 20 - 49 Employees)
C.
( 50 - 99 Employees)
D.
E.
( 100 - 499 Employees)
5. Which of the folowing best matches your age group?
(Please Write in ONE Choice in the box to the left)
A.
!
18 - 24
B.
25 - 35
C.
36 - 45
Register On-Line at: www.registermybrother.com
Brother Product Registration
Last Name
!!!!!!!!!!!!!!!!!!!
Model Number
!!!!!!!!!!!!!!!!!!!
Serial Number
!!!!!!!!!!!!!!!!!!!
F.
Friend / Relative
G.
Dealer / Store Display
H.
Business Associate
I.
Brochure
J.
Other
F.
Printer
G.
Sewing Machine
H.
Stamp Creator
I.
Typewriter
G.
Size / Weight
H.
Store Flyer / Display
I.
Styling / Appearance
J.
Quality / Reliability
K.
Warranty
L.
Other
F.
(500 and Over)
G.
Personal Use
H.
Student Use
I.
Other
D.
46 - 55
E.
56 - 64
F.
65 and over
Purchase Date ( MM - DD - YYYY )
6. Which best describes your occupation?
(Please Write in ONE Choice in the box to the left)
A.
Business Owner
!
B.
Clerical / Service
C.
Homemaker
D.
Management
E.
Professional / Technical
F.
Retired
7. Which Hobbies do you enjoy?
(Please Write in top 3 choices in the boxes to the left)
A.
Arts / Antiques
!!!
B.
Cooking
C.
Crafts
D.
Decorating
E.
Electronics
8. Which of the following magazines / publications do you read regularly?
(Please Write in top 3 choices in the boxes to the left)
A.
Business Week
!!!
B.
Computer Shopper
C.
Consumer Reports
D.
Forbes / Fortune
E.
Macworld / Mac Home
Would you like to receive Brother information regarding?
Special offers, rebates and discounts?
New software, drivers and service related updates?
Newsletters and surveys?
Website updates and enhancements?
Please make sure you FILL in your choices completely.
To view our privacy policy, go to www.registermybrother.com
Or
Fax this side to 1-877-518-5702
State
Zip Code
!! !!!!!
G.
Sales / Marketing
H.
Student
I.
Teacher / Professor
J.
Tradesman / Laborer
K.
Other
F.
Gardening
K.
Sewing
G.
Internet / PC
L.
Sports
H.
Music
M.
Travel
I.
Photography
N.
Other
J.
Reading
F.
Newsweek / Time
G.
PC Magazine
H.
PC World
I.
C/Net (Online)
J.
Other
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YES
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YES
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@
YES
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YES
NO
NO
NO
NO
Publicidad
