66 Please indicate the serial number(s) of this product Pleaseindicatethe serial number(s)of this product
77
8a
8b
9
10
(Foundon the ID label attachedto your product or consult your owner’s manualfor the location)
on the 10 label to your product or consult your owner's for the location)
Serialnumber(s)
Wherewas product purchased
. 0 Bose(3) |
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1, 0 |
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2.0 | BoseWeb site |
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2. q |
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0 | Bosestore |
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3. 3 |
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0 | Retailstore |
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4. fl |
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Name: |
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City’City' |
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5.. il[J Catalog |
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6..U0 OtherWeb site |
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7..30 Other |
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Doyou own any other Bose products? | 1I..2J | Yes 2.. _ No | |
Whichones? |
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1..0 Lifestyle@Lifestyle”system | 5 L Headset | ||
2.0 | Wave’:radio/AcousticWave'Wave; system | 6 J2 Other Bose speakers | |
| 3 |
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3..0q Automobilesoundsystem | C | Other | |
7 [] | |||
4..0 Acoustimass'Acoustimass”speakers
Dateofyourbirth:(month/day/year)
Includinglncludinoyourself,vourself,whatisthetotal@&Inumberof peoplelivingin your household?
(Example:01,02,.03,.04 ))
11 Dateofbirth(month/year)oftheotheradultsandchildreninyour household. .
Male Female
Male Female
| 11..0 22.0 | Month |
| Year | 1 - | 2. - |
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| 11..0 22..0c |
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| 1. = | 2.= |
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| Year |
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| YEI | ||
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12 | Your |
| 1 ti | Male | 2 1 | Female |
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Your gender: |
| Male | 2 = Female |
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13 Yourmaritalstatus: | 1 _JMarried | 2. II | Single |
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13 | Your marital status: | 1 _J | Married | 2. | Single |
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14 | For | primaryresidence,do you: | l.,Own |
| 2 7 | Rent |
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For yourprimary residence, do you: | 1. =: Own | 2 | =:: | Rent |
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