Registration Card
First Name:
Last Name:
Company Name:
Address:
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Zip:
Phone:
Email:
Purchased From
Dealer Name:
Address:
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Zip:
Type of Business:
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Building Service Contractor
Carpet Cleaners
Convenience Stores
Distributor
Education Higher Education
Education K-12
Floor Installation/Builders
Food Service
Health Clubs
Healthcare - Hospitals
Healthcare - Senior Living
In-House Professional
Industrial
Lodging
Municpal Government
Pest Management
Religion
Residential
What do you plan to use your vacuum on MOST?
Carpet
Detail - Stairs
Hard Surfaces
Wood Flooring
Date Purchased:
Model:
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Serial #:
Why did you buy?
(for example Advertising, Price/Sale, Referral, Shop Employee, Other etc.)
What is your overall satisfaction with this product (scale of 1 – 5, where 5 = very satisfied and 1 = very unsatisfied)
1
2
3
4
5
What are your recommended improvements to this product?
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