Product Registration
 Please review the errors below: (Questions with errors are marked with "X")
Required fields are indicated with *
  1. Name & Address:  
     
    Title
       First     Initial     Last 
    Street
       Apt. 
    City
       State/Prov    
    Zip/Postal code
       E-mail 
  2. Your date of birth:
  3. Marital status: Married Single
  4. Date of purchase: 
  5. Date of installation: 
  6. Model number:    Serial number:
  7. Price paid (excluding sales tax): $ .00
  8. Name of store where purchased:
  9. How did you first become aware of Casablanca products?
  10. Which factors most influenced your decision to purchase this Casablanca product? (check up to three)
    Friend/Relative
            recommendation

    Brand reputation
    Previous experience with brand
    Price
    Product advertising
    Salesperson recommendation

    Visited web site
    In-store display
  11. Which features most influenced your decision to purchase this Casablanca product? (check up to three)
    Overall appearance
    Color/Finish
    Durability
    Quiet operation
    Selection of accessories
    Special features
    Warranty
    Remote control
    Other
  12. Is this the first:
    Ceiling fan you have ever owned?     Yes     No
    Casablanca ceiling fan you have ever owned?     Yes     No
  13. This fan was purchased:
  14. In what room did you install this fan?
  15. Are there others living in your household? Yes No  
    Select the gender and ages of the other adults and children living in your household.
    1.      3.     
    2.      4.     
  16. Occupation/Employment status: (check all that apply)
      You Spouse   You Spouse
    Professional/Technical Healthcare - Physician/Nurse/Other
    Upper management/Executive Homemaker
    Middle management Military
    Sales/Marketing Retired
    Clerical/Service worker Self employed/Business owner
    Tradesman/Machine op./Laborer Work from home office
    Teacher/Educator  
  17. Which group describes your annual family income?
  18. Level of education:
  19. For your primary residence, do you:  Own?  Rent?
  20. What type of internet access do you use at home?
  21. Please indicate the items that you or someone in your household have/own.  
    Wireless handheld device
            (e.g. Blackberry)
    GPS locator
    MP3 player (e.g. iPod)
    Wireless internet connection
    Flat-panel TV
    High def enabled TV
            (HDTV)
    Home theater system
    Digital video recorder
            (DVR)
    Gaming system
    Satellite radio
    Apple computer
    PC (e.g. Dell, IBM)
  22. When new products that have the latest technologies appear on the market, do you or someone in your household:
     
    Tend to buy such items as soon as they are available?
    Tend to wait until the item has been around for a while before buying?
  23. 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.
     
    Home Life
    Grandchildren
    Home improvement/
            Do-it-yourself
    Gardening
    Own a dog
    Own a cat

    Leisure
    Cultural/Art events
    Avid book reading
    Bible/Devotional reading
    Gourmet cooking/Fine
            foods
    Wines
    Art/Antique collecting
    Stamp/Coin collecting
    Crafts
    Sewing/Needlework/
           Knitting
    Travel
    Airline club/Frequent
            flyer
    Travel in USA
    Foreign travel
    Cruise ship vacations
    RV vacations
    Casino gambling

    Investing and Money
    Shopping by
            catalog/mail order
    Shopping by internet
    Use credit cards
            regularly
    Donate to charitable
            causes
    Investments/Money
            making opportunities
    Contests/Sweepstakes
    Great Outdoors
    Hunting/Shooting
    Fishing
    Camping/Hiking
    Wildlife/Environmental
            issues
    Boating/Sailing

    Sports, Fitness & Health
    Physical
            fitness/Exercise
    Walking for health
    Health/Natural foods
    Dieting/Weight control
    Self-improvement
    Golf
    Biking
    Snowboarding/Snow
            skiing
    NASCAR
  

  
Your Privacy Rights

This statement discloses the privacy practices of this Product Registration website. We believe you should know:

1. What information this site gathers about you
2. What this site does with the information it tracks
3. With whom this site shares the information it gathers

We collect personal information about our users only during product registration. We do not use cookie technology to track your movements.

We respect your right to privacy. As part of the entry process, we give you the opportunity to decline to receive any communications from other parties to whom we may provide such information.

The data we collect is used in the aggregate to give us demographic information about the entire audience registering their products. We use this to understand that audience and to improve our offerings to you, our customers.

The personal information you provide - name, address, etc. - allows us to inform you of additional special offers which may be forthcoming, and to send you coupons, or notify you of products and services of our affiliates that relate directly to your specific interests, hobbies or other information you have given.

Security
All data is stored in a highly secure database with state of the art backup and firewall technologies. It is not accessible to any unauthorized parties. This means that your information is kept safe, and is only disclosed to selected third parties to provide you with valuable information and special offers.

I do not want to receive coupons, mailings, or other special offers

Failure to submit this registration will not diminish your warranty rights.

If you have questions or concerns about this site click here.