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6
Please indicate the serial number(s) of this product
(Found on the ID label attached to your product or consult your owner’s manual for the location )
Serial number(s)
7 Where was product purchased
1, 0 Bose’” l-800 number
2.
q
Bose Web site
3. 3 Bose store
4. fl Retail store
Name:
City’
State
5. il Catalog
6. U Other Web site
7. 3 Other
8a
Do you own any other Bose products?
I.2 Yes 2. _ No
8b
Which ones?
1. 0
Lifestyle” system
5 L Headset
2. 0
Wave’: radio/Acoustic Wave;
system
6 2 Other Bose speakers
3.
q
Automobile sound system
7 C Other
4.0 Acoustimass” speakers
9 Date of your birth: (month/day/year)
10
lncludino vourself, what is the @&I number of people living in your household?
(Example:
01, 02. 03. 04 )
11
Date of birth (month/year) of the other adults and children in your household.
Male Female
1.0 2.0
Month
1.0 2.c
Month
12 Your 1 ti Male 2 1
gender:
Female
13
Your marital status: 1 _J Married
2. II Single
14 For primary residence, do you:
your
l.,Own
2 7 Rent
Year
YEI
6
Please
indicate
the
serial
number(s)
of
this
product
(Found
on
the
10
label
attached
to
your
product
or
consult
your
owner's
manual
for
the
location)
Serial
number(s)
7
Where
was
product
purchased
1.
0
Bose(3)
1-800
number
2.0
Bose
Web
site
3.
0
Bose
store
4.
0
Retail
store
Name:
City'
State
5.
[J
Catalog
6.0
Other
Web
site
7.0
Other
5
Headset
6 J
Other
Bose
speakers
7
[]
Other
2.
_
No
1.
J
Yes
8a
Do
you
own
any
other
Bose
products?
8b
Which
ones?
1.
0
Lifestyle@
system
2.0
Wave
3
radio/Acoustic
Wave'
system
3.
0
Automobile
sound
system
4.
0
Acoustimass'
speakers
9
Date
of
your
birth:
(month/day/year)
10
Including
yourself,
what
is
the
total
number
of
people
living
in
your
household?
(Example:
01, 02,
03,
04
)
11
Date
of
birth
(month/year)
of
the
other
adults
and
children
in
your
household.
Male
Female
Male
Female
1.0
2.0
1
-
2.
-
Month
Year
Month
Year
1.0
2.0
1.
=
2.=
Month
Year
Month
Yeal
12
Your
gender:
Male
2 =
Female
13
Your
marital
status:
1
_J
Married
2.
Single
14
For
your
primary
residence,
do
you:
1.
=:
Own
2
=::
Rent