Air Cleaner Registration Thank you for choosing Austin Air. Please take a few moments to activate your warranty by completing this form. * Denotes required fields for product registration. 1. Name & Address * First Name   Initial(s) * Last Name * Street   Apt. No. * City * State/Province * ZIP/Postal Code * Country U.S.A.Canada Telephone Number E-mail Address 2. Product Information * Model * Color * Serial Number * Serial Number Verification HealthMateHealthMate Jr.Allergy MachineAllergy Machine Jr.HealthMate+HealthMate+ Jr.Baby's BreathPet Machine (Found on the back of your Austin Air cleaner) show me * Store/Dealer where purchased   (or) If purchased Online http:// * Date of Purchase or Received JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 12345678910111213141516171819202122232425262728293031 200020012002200320042005200620072008 3. Reason for purchasing (check all that apply): General Air Quality Concern Asthma Chemicals / Gases Odors Allergies Pet Dander Improve Sleep Children Reduce congestion Reduce snoring Other:  (Please Specify) 4. Where will your Austin Air cleaner be used? Bedroom Family Room Child's Bedroom Living Room Improve Sleep Office Other:  (Please Specify) 5. Is your Austin Air cleaner... The first air cleaner in your household? An addition to an Austin Air cleaner in your household? An addition to another brand of air cleaner in your household? A replacement for an Austin Air cleaner? A replacement for another brand of air cleaner? 6. How did you hear about Austin Air? Print Ad Physician Word of Mouth Television Store Internet Search Recommended by friend/relative Other:  (Please Specify) 7.  Select the most important factors influencing your purchase of this product. (check all that apply) Austin Air Brand Reputation Prior Experience with Austin Air Style / Color / Appearance Price Warranty Quality / Durability Ease of Use Friend's / Relative's Recommendation Salesperson's Recommendation TV Ad Magazine Ad Newspaper Ad Radio Ad Special Promotion / Value Added Store Display Made in the U.S.A. Other:  (Please Specify)   YES! I would like to receive information about special offers, promotions and new product information via e-mail.

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