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Three Important Reasons to Register Your Product Immediately!

1. Protect Your New Investment... Register your new Bread Maker 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. Why did you purchase this product?
    Received as a Gift
    To replace a broken unit
    To upgrade to a new model     		Moved into a new house
    Remodeled kitchen
    To begin baking your own bread
    11.  
  11. From what type of store was this product purchased?
    Received as a Gift
    Electronics Superstore (Best Buy or
          Circuit City)
    Mass Merchandise Store (Kmart, Target,
          Wal-Mart, etc.)
    Sears
    TV/Appliance Store
    Membership Warehouse Club
    Department Store     		Catalog Showroom
    Internet
    Mail Order
    Drug Store
    Grocery Store
    Supermarket
    Other
    12.  
  12. How did you first learn of this product?
    Magazine ad
    Newspaper ad
    Radio ad
    Television ad
    Direct mail catalog or offer     		Friend's/Relative's Recommendation
    Salesperson's Recommendation
    In-store display
    In-store catalog
    Other
    13.  
  13. What other brand(s) did you seriously consider before selecting Panasonic? (check all that apply)
    Did not consider any other brands
    Regal
    Welbilt
    Oster
    Breadman
    Toastmaster     		Westbend
    Sunbeam
    Magic Chef
    White Westinghouse
    Zojirushi
    Other
    14.  
  14. What were the three (3) most important factors that influenced your selection of this product?
    Trust in Panasonic
    Quality
    Features
    Price
    Size
    Appearance/Design     		Ease of Operation
    Warranty/Service
    Salesperson's Recommendation
    Friend's/Relative's Recommendation
    On-line Research
    Other
    15.  
  15. What were the three (3) most important functions that influenced your selection of this product?
    Automatic Yeast Dispenser
    2.5 lb Big Capacity
    Loaf Size Control
    Crust Color Control
    Non Stick Coated Pan     		Various Bread Modes
    13-Hour Digital Timer
    Rapid Bake Mode
    Built-In Safety Devices
    Other
    16.  
  16. What is the most important benefit of owning a bread machine? (please choose one)
    A Bread maker:
    Makes better tasting bread
    Cooks bread faster and easier
    Makes bread without any preservatives     		Makes gluten free bread
    Makes various breads
    Makes perfect bread every time
    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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