Capresso Product Registration

Select one:

Please complete this registration after you have used your machine for a few days. Your information will help us to better serve you in the future.

Thank you for buying from Capresso.

Please print clearly

Last Name_________________________________________________________________

First Name_______________________________________________ ❑ Male ❑ Female

Address___________________________________________________________________

City_________________________________________State_______Zip________________

Your Email Address_________________________________________________________

Purchased from: ❑ Specialty store ❑ Mail order ❑ Department Store

❑Website ❑ Received as gift

Name of retailer_____________________________________________________________

Purchase Date_______________ Purchase Price $_____________

❑ Concept/Features ❑ Stainless steel heating element ❑ Metal housing

❑Design ❑ Print advertising ❑ Store recommendation ❑ Recommended by friend

I drink (mark all that apply):

❑ Regular coffee

❑ Cappuccino

❑ Latte ❑ Espresso

❑ Hot Chocolate

What other coffee maker did you use before?:

❑None ❑ Mr. Coffee ❑ Braun ❑ Krups ❑ Cuisinart ❑ Capresso

❑Other:______________________________

Would you like more information about our products?: ❑ Yes ❑ No

Your annual household income:
❑ Under $50,000	❑ $50,000 – $100,000 ❑ $100,000 – $250,000	❑ $250,000 +
Your age group:	❑ Under 25 ❑ 25–40 ❑ 41–45 ❑ 46-55 ❑ 56-65	❑ 65 +

Any suggestions on how we can improve this product?

___________________________________________________________________________

Would you recommend this product to your friends?: ❑ Yes ❑ No

Mail to Jura-Capresso Inc., P.O. Box 775, CLOSTER, NJ 07624

or FAX to: (201) 767-9684.