Product Registration
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Three Important Reasons to Register Your Product Immediately!

1. Protect Your New Investment... Register your new Photo Printer for insurance purposes in case it is lost or stolen.
2. Product Safety Notification... Registering your product can help us to contact you in the unlikely event a safety notification is required under the Consumer Product Safety Act.
3. Improved Product Development... Help us continue to design products that meet your needs.

It is not necessary to submit this form in order to effectuate the limited warranty.

  1. Name & Address:  
     
    * Title Mr.    Mrs.    Ms.    Miss
    * First Name Initial * Last Name
           
    * Street Apt. No. * City
    * State/Province * Zip/Postal Code
    2.  
  2. Email Address:
    YES! I would like to receive information from Panasonic about special offers, promotions
    and new product information via e-mail
    3.  
  3. Telephone Number: ( ) -
    4.  
  4. Date of purchase: 
    5.  
  5. Model number: (refer to operating manual or box)
    6.  
  6. Serial number: (refer to the product)
    7.  
  7. Name of store where purchased:
    City:  State:
    OR
    Website address if purchased via the Internet:
    8.  
  8. Price paid: (excluding service contract, shipping and taxes) $ .00
    9.    
  9. Did you purchase or receive an extended service contract with your product?
    Yes No
    10.  
  10. Is this product: (check all that apply)
    The first product of this type you've ever purchased?
    A replacement for another product?
    An additional product (already own one other)?
    An additional product (already own two or more other)?
    11.  
  11. Where was this product purchased?
    Received as a Gift
    Camera Store
    Computer Store
    Office Superstore
    Electronics Superstore (Best Buy, Circuit
          City)
    TV/Appliance Store
    Audio/Video Specialty Store    		 Mail Order
    Mass Merchandise Store (Kmart, Target,
          Wal-Mart, etc.)
    Sears
    Department Store
    Membership Warehouse Club
    Catalog Showroom
    Other:
    12.  
  12. A. Did the salesperson demonstrate the product?
    Yes No

    B. If yes, how would you rate the salesperson's knowledge of of the product?
    Not at all knowledgeable -----------------> Very Knowledgeable
    1. 2. 3. 4. 5.
    13.  
  13. What were the most important factors that influenced your selection of this product?
    (check up to 2)
    Trust in Panasonic
    Price
    Quality
    Features
    Appearance/Design
    Ease of Operation    		 Size
    Warranty/Service
    Finish/Color
    Recommendation
    Other
    14.  
  14. What features most influenced your selection of this model? (check up to 2)
    Picture Quality
    PC Card Input
    S-Video In Terminals
    Composite NTSC In/Out
    Print Functions (Album & Multi)    		 Computer Interface (Windows & Macintosh)
    Pre-Set Title Option
    Printout Time
    8-Color Title Function
    Other
    15.  
  15. What other brand(s) did you seriously consider before selecting Panasonic? (check all that apply)
    Did not consider any other brands
    Epson
    Canon
    Fuji
    HP    		 Kodak
    Olympus
    Casio
    JVC
    Other
    16.  
  16. Excluding this purchase, what other electronic equipment do you currently own or intend to purchase? (A) If You Currently Own (B) If It’s Panasonic or Technics (C) Intend to Buy in The Next 6 Months

    A. If you currently own:
    B. If it's a Panasonic or Technics
    C. Intend to buy in the next 6 months
    HiFi VCR
    TV/VCR Combination
    27" or Larger Color TV
    Projection TV
    Digital TV
    DVD Player (excluding PC DVD)
    Digital Satellite System
    Camcorder
    Digital Camcorder
    Digital Camera
    Compact Disc Changer
    Dolby Digital Receiver (AC-3)
    900 MHz Cordless Phone
    Fax Machine
    Home Computer
    17.  
  17. Your date of birth:
    18.  
  18. Marital Status: Married Single
    19.  
  19. Please check all that apply to your household.
    Own a Compact Disc Player
    Subscribe to an Online/Internet Service
    Own an IBM or Compatible Computer     		Own an Apple/Macintosh Computer
    Own a CD-ROM
    20.  
  20. Which group describes your annual family income?
    Under $15,000
    $15,000-$19,999
    $20,000-$29,999
    $30,000-$39,999
    $40,000-$49,999     		$50,000-$59,999
    $60,000-$74,999
    $75,000-$99,999
    $100,000-$124,999
    $125,000-$149,999     		$150,000-$174,999
    $175,000-$199,999
    $200,000-$249,999
    $250,000 & over
    21.  
  21. Which of the following do you plan to do within the next 1-6 or 7-12 months?
    (select all that apply)
      1-6 Months 7-12 Months
    Get Married
    Have a Baby
    Buy a House
    Remodel a Home
    Move to a New Residence
    Buy a Personal Computer
    Buy/Lease a New Vehicle
    Buy/Lease a Used Vehicle
    22.  
  22. Not including yourself, what is the GENDER and AGE (in years) of children and other adults living in your household?
    No one else in household     Child under 1 year
    1.  Male   Female   Age (in yrs):
    2.  Male   Female   Age (in yrs):
    3.  Male   Female   Age (in yrs):
    4.  Male   Female   Age (in yrs):
    23.  
  23. Which credit cards do you use regularly?
    American Express, Diners Club
    MasterCard, Visa, Discover     		Department Store, Oil Company, etc.
    Do not use credit cards
    24.  
  24. For your primary residence, do you:
    Own?     Rent?
    25.  
  25. 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.
    01. Gardening
    02. Hunting/Shooting
    03. Bible/Devotional Reading
    04. Travel in USA
    05. Cruise Ship Vacations
    06. Photography
    07. Avid Book Reading
    08. Foreign Travel     		09. Home Workshop/Do-It-Yourself
    10. Our Nation’s Heritage
    11. Golf
    12. Wildlife/Environmental Issues
    13. Fishing
    14. Physical Fitness/Exercise
    15. Entering Sweepstakes
    16. Casino Gambling     		17. Dieting/Weight Control
    18. Wines
    19. Gourmet Cooking/Fine Foods
    20. Bicycling
    21. Health/Natural Foods
    22. Self-Improvement
    23. Stocks/Bonds/Mutual Funds
    24. Watching Sports on TV
    26.  
  26. Using the numbers in the above list, please indicate your 3 most important activities:
           




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.
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