Registering your product with Clark Enterprises will help us better serve all of your support and warranty needs, should they arise. First Name: Last Name: Street: Apt. / Suite Number: City: State: Zip: Email Address: I received the product as a gift. The person who purchased the machine is: Name of machine I am registering: Serial Number: Date of purchase: Month January February March April May June July August September October November December Year 2009 2010 2011 2012 2013 2014 2015 Your responses to the following optional questions below will help us develop new products and services. Date of birth: Month January February March April May June July August September October November December Year 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 What were the most important factors that influenced your purchase decision? (check up to 3)  Advertising  Appearance / Design  Customer Service  Referral / Recommendation  Gift  Money Back Guarantee  Product Features  Quality  Value for price  Warranty  Other Occupation (check all that apply) Yourself: Spouse:  Professional/Technical  Upper Management/Executive  Middle Management  Sales/Marketing  Clerical/Service Worker  Machine Operator/Laborer  Professional/Technical  Upper Management/Executive  Middle Management  Sales/Marketing  Clerical/Service Worker  Machine Operator/Laborer Are you or your spouse: Yourself: Spouse:  A Homemaker?  Retired?  A Student?  Self Employed?  Work From Home?  In the Military? A Veteran?  A Homemaker?  Retired?  A Student?  Self Employed?  Work From Home?  In the Military? A Veteran? Which group describes your annual family income? select Under $20,000 $20,000-$39,999 $40,000-59,999 $60,000-79,999 $80,000-$99,999 $100,000-$124,999 $125,000-$199,999 $200,000 & over For your primary residence, do you: select Own? Rent? To help us understand our customers’ lifestyles, please indicate the interests and activities in which you or your spouse enjoy participating on a regular basis.  Bicycling  Golf  Physical Fitness / Exercise  Running / Jogging  Snow Skiing  Health / Natural Foods Photography  Cultural / Arts Events  Fashion Clothing  Art / Antique Collecting  Tennis  Camping / Hiking  Fishing  Hunting / Shooting  Boating  Sewing  Needlework / Knitting  Gardening  Crafts  Electronics  Recreation Vehicles  Avid Book Reading Foreign Travel  Travel in USA  Gourmet Cooking / Fine Foods  Wines  Stamp / Coin Collecting  Collectibles  Wildlife / Environmental Issues  Dieting / Weight Control  Science / New Technology  Self-Improvement