Cut along dotted line and send to: AMERIPHONE, Inc., 12082 Western Ave., Garden Grove, CA 92641
OWNER REGISTRATION CARD
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| Thank you for purchasing your AMERIPHONE | 8. | Is this TTY |
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| DIALOGUE TTY. Please fill out and mail this card |
| 1. | Your first TTY |
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| Within The Next 10 Days to register your purchase. |
| 2. | A replacement for any other TTY | |||||||||||||||
| Proper registration will enable us to send you period- |
| 3. | An additional TTY |
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| ic mailings about new products and other important |
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| announcements, and also allow us to contact you in | 9. | Which brands did you most seriously | ||||||||||||||||
| the unlikely event that your product needs adjustment |
| consider before buying your Ameriphone | ||||||||||||||||
| or modification. THANK YOU! |
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| TTY? (Check all that apply.) | |||||||||||||
| 1. |
| __Mr. | __Mrs. __Ms. |
| __Miss |
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| 1. | Ultratec |
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| 2. | Krown |
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| 3. | AT&T |
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| First Name | Initial |
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| Last Name |
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| 4. | Other |
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| Street |
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| Apt.No. |
| 10. | What were the most important factors | |||||||||
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| influencing your decision to purchase this | |||||||
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| TTY? (Please check a maximum of two.) | |||||||||||
| 2. |
| Date of Purchase: |
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| 1. | Emergency Call Announcer (ECA) | |||||||||
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| 2. | Ease of converting from display to | |||||||||||
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| Month | Day | Year |
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| printer TTY |
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| 3. Model & Serial Number: |
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| 4. |
| Home Telephone No.: | ( | ) | - |
| 4. | Printer letter sizes |
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| 5. | Electronic Voice Announcer | |||||||||||||||
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| 6. | Compact size |
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| 5. Where did you purchase this product? |
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| 7. | Light weight |
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| 1. | Received as a gift |
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| 2. | Assistive Device specialty store |
| 8. | Ease of use |
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| 3. | Department store |
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| 9. | Other |
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| 4. | TV/appliance store |
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| 5. | Catalog showroom |
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| 11. | Did you purchase a factory extended | |||||||||||
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| 6. | General Merchandise store |
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| warranty on your DIALOGUE TTY? | ||||||||||||||
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| (Sears,Penneys,Wards,Etc) |
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| 1. | Yes |
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| 7. | Discount store |
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| 2. | No |
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| 8. | Mail order |
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| 9. | Other |
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| 12. | Where did you purchase the extended | |||||||||
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| 6. | How did you first become aware of this |
| warranty? |
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| product? (Please check only one.) |
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| 1. | AMERIPHONE |
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| 1. | Magazine advertisement |
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| 2. | Dealer: |
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| 2. | Newspaper advertisement |
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| 3. | TV advertisement |
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| Name |
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| 4. | Information received through the mail |
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| Address |
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| 6. | Friend’s/Relative’s recommendation |
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| 7. | Salesperson’s recommendation |
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| 8. | Product brochure |
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| 7. | Excluding sales tax, how much did you | Zip Code |
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| 1. | Less than $200 |
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| 13. How long of an extended warranty? | ||||||||||||
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| 2. |
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| 1. | 2 years |
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| 3. |
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| 2. | 1 year |
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| 5. |
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| 14. How much did you pay for the extended | |||||||||||
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| warranty? |
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| 7. |
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| $___________. | 27 |