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Customer Care Registration
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For easy on-line registration, go to
Thank you for choosing Alpine! Please register your product with us so we can serve you better.
First name:
_
Last name:
_
Home address:
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City
State/Provo
Zip Code
May we contact you at this address? 1.0 Yes 2. 0 No
Phone number: (
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May we contact you at this number?
1.0Yes 2.0 No
E-mail Address:
o
Gender
1.0 Male
2. 0 Female
o
Date of Birth
Month:
Year:
= - - - -
o
Marital Status
1.0 Single
2.0 Married
OWhich ethnicity best describes yourself:
1.0 Caucasian
4.0 Asian
2.0 Hispanic
5.0 Other
_
3.0 African-American
OYour highest level of education completed:
1.0 High School Student
2.0 High School Graduate
3.0 2 Yr. Degree/Some College
4.0 Completed 4 Yr. College
5.0 Completed Graduate School
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Model Year:
_
Purchased Year:
_
o
How was this vehicle purchased?
1.0 Bought
2.0 Leased
o
When you purchased this Alpine unit, did you
compare it with other brands?
1.0Yesj,
2.0 No.
(Brand Name)
_
o
Which of the following statements best describes you?
1.0 I usually have more electronic equipment than my friends
2.0 I am usually one of the first of my friends to buy the newest
electronic equipment
3.0 I usually wait until a product has been out for a while before
I purchase it
4.0 I am usually on of the first of my friends to know about the
newest car
5.0 I usually know more about cars than my friends
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0
Occupation
1.0 Executive/Managerial
6. 0 EngineeringlTechnical
2.0 Secretarial/Clerical
7. 0 Farming/Fishing
3.0 Sales
8. 0 Retired
4.0 General Labor
9. 0 Student
5.0 Professional
10.0 Other
_
o
Household Income
1.0 Less than $30,000
4.0 $70,000 - $90,000
2.0 $30,000 - $50,000
5.0 $90,000 - $110,000
3.0 $50,000 - $70,000
6.0 Over $110,000
OType of vehicle in which this unit is installed.
Make:
Model:
_
9. 0 Monitor Controller
10.0 Video Monitor
11 .
0 Navigation
12.0 Mobile Mayday
13.0 Video Tape Player
14.0 Processor/Equalizer
15.0 Security
16.0 Other - - - -
_
o
Product purchased
1. 0 Casselle Player
2.0 CD Player
3.0 MD Player
4.0 DVD Player
5.0 CD Changer
6.0 Amplifier
7.0 Speaker
8.0 Subwoofer
o
Model Number:
_
o
Serial Number:
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Date of Purchase:
Month:
Year:
_
o
If navigation system, which monitor?
1.0 Alpine ---7 (Model No.)
- - - - - - - - - - - -
2.0 Other ---7 (Brand Name)
- - - - - - - - - - -
o
Purpose of buying this unit?
1.0 Addition
2.0 Replacement---7
*Previous brand replaced?
1.0 Factory installed
2.0 Alpine
3.0 Other
_
o
Have you purchased Alpine products before?
1.0 First time
2.0 Two or more limes
1.0Yes 2.0No
May we contact you bye-mail?
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Thank you for your cooperation
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We value your privacy. This information will remain confidential with Alpine and its affiliates.
Customer Care Registration is for Product registration.
Failure to complete and return this card does not diminish your warranty rights.
PART NO. 68P04190K17-A
M3544084010
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