Brother Product Registration; Register On-Line at: www.registermybrother.com Or Fax this side to 1-877-518-5702; 7. Which Hobbies do you enjoy?- Page 6

Register On-Line at:  www.registermybrother.com        Or      Fax this side to 1-877-518-5702

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A.
B.
C.

D.
E

.

F.
G.
H.

I.
J.

Newsweek / Time
PC Magazine
PC World

C/Net (Online)
Other

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7.  Which Hobbies do you enjoy?

(Please 

Write

 in top 3 choices in the boxes to the left)

Arts / Antiques

Cooking
Crafts
Decorating

Electronics

A.

B.
C.
D.

E.

Gardening
Internet / PC
Music

Photography
Reading

F.
G.
H.

I.
J.

Sewing
Sports

Travel
Other

K.
L.

M.
N.

8.  Which of the following magazines / publications do you read regularly?

(Please 

Write

 in top 3 choices in the boxes to the left)

6.  Which best describes your occupation?

  (Please 

Write

 in 

ONE

 Choice in the box to the left)

Business Week
Computer Shopper
Consumer Reports

Forbes / Fortune
Macworld / Mac Home

Brother Product Registration

!

1.  How did you first become aware of this Brother product?

 (Please 

Write

 in 

ONE

 Choice in the box to the left)

Friend / Relative

Dealer / Store Display
Business Associate
Brochure

Other

F

.

G

.

H

.

I.

J

.

Magazine Advertisement

Newspaper
TV Advertisement
Radio Advertisement

Brother Website / Internet

A

.

B

.

C

.

D

.

E

.

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2.  What other Brother products do you own or have you purchased
     in the past?

(Please 

Write

 in top 3 choices in the boxes to the left)

Embroidery Machine
Fax Machine
Label Maker

Laminator
Multifunction

A.

B.
C.
D.

E

.

Printer
Sewing Machine
Stamp Creator

Typewriter

F.
G.
H.

I.

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Advertisement
Brother’s Reputation

Ease of Use
Features
Friend / Relative

Price / Value

3.  Which of the following factors influenced your decision
     to buy this product?

(Please 

Write

 in top 3 choices in the boxes to the left)

Size / Weight
Store Flyer / Display

Styling / Appearance
Quality / Reliability
Warranty

Other

G.
H.

I.
J.
K.

L.

A.
B.

C.
D.
E.

F.

!

4.  Please Select the Primary use for this product?

  (Please 

Write

 in 

ONE

 Choice in the box to the left)

Business Use   ( 1 - 5 Employees)

( 6 - 19 Employees)
( 20 - 49 Employees)
( 50 - 99 Employees)

( 100 - 499 Employees)

A.
B.

C.
D.
E

.

(500 and Over)
Personal Use

Student Use
Other

F.
G.

H.
I.

!

5.  Which of the folowing best matches your age group?

(Please 

Write

 in 

ONE

 Choice in the box to the left)

46 - 55
56 - 64

65 and over

D.

E.
F.

18 - 24
25 - 35

36 - 45

A.
B.
C

.

!

Would you like to receive Brother information regarding?

@

@

@

@

@

@

@

@

YES

YES

YES

YES

NO

NO

NO

NO

Please make sure you FILL in your choices completely.

Special offers, rebates and discounts?

New software, drivers and service related updates?

Newsletters and surveys?

Website updates and enhancements?

To view our privacy policy, go to www.registermybrother.com

Business Owner
Clerical / Service

Homemaker
Management
Professional / Technical

Retired

A.
B.

C.
D.
E.

F.

Sales / Marketing

Student

Teacher / Professor

Tradesman / Laborer

Other

G.
H.

I.
J.
K.

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City

!!!!!!!!!!!!!!!!!!!!!!!

State

  Zip Code

!!!!!!!!!!!!!!!!!!!!!!!!!!

E-Mail Address

Store Where Purchased

       Purchase Date  ( MM - DD - YYYY )

Model Number

Serial Number

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Telephone Number

Fax Number

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Company Name

Last Name

First Name

Address