Product Registration Form

Thank you for purchasing this Ideal Home Innovations product. Answering the following questions will register your product and help us bring more innovative products to you.

1.	Mr.		Mrs.		Ms.		Miss
	First Name:		Initial		Last Name:
	Street:		Apt. No.
	City:		State:		Zip:
	Email:

2.

Date of Purchase/Receipt:

Month:

Day:

Year:

3.

Where was the product purchased from?

Retail Store

Catalog

Internet

Other

Store Name:

4.	What is the gender of the product's primary user?	Male	Female
5.	What is your age group?	18-24	35-44	55-64	25-34	45-54	65 or older

6.

Overall, how satisfied are you with your FRESHhanger?

Very Satisfied

Somewhat Satisfied

Somewhat Dissatisfied

Very Dissatisfied

7.	What do you like best about your FRESHhanger?
8.	What would improve FRESHhanger?
9.	What other FRESHhanger type products would you like to see us develop and sell?