Z Star Manual Juicer

Registration Information

Title:
First Name:
Middle Initial:
Last Name:
Street Address:
City:
State:
Zip:
Phone:
E-mail:
Model Number:
Serial Number:
Date of Purchase: / /20


Dealer Information

Name of Dealer:
Address:
Phone:

Optional Survey

How did you first become aware of the Z Star Manual Juicer?

What factors most influenced your decision to purchase the Z Star Manual Juicer?

For your primary residence, do you:

Occupation?

Which group describes your annual family income?

Which credit cards do you use regularly?


Do you have internet service?
Yes No

Have you ever purchased any products through online stores?
Yes No

Do you use email in your business communication?
Yes No

Do you use email in your personal communication?
Yes No

Do you regularly purchase items through the mail?
Yes No

Is there a military veteran in household?
Yes No

Are you a member of frequent flyer programs?
Yes No

Do you support health charities?
Yes No

Do you subscribe to cable TV?
Yes No

Do you use a personal computer?
Yes No

Do you have a microwave oven?
Yes No

Do you have a CD player?
Yes No

Do you have a VCR?
Yes No

Do you have a pet?
Yes No

We value your privacy! We will NEVER share your information with 3rd parties unless it is necessary to conduct business with you (for example, with our courier to send your orders to you) or if it is required by law.

From time to time, we would like to send you important information, like product updates or special offers. Please mark "yes" below if you would like to receive important product information, product updates, or special offers from Tribest. If you do not wish to receive the important product updates and special offers from Tribest, please mark "no."

Yes No