Product Registration

PRODUCT REGISTRATION Form

PERSONAL INFO
Full name *
E-mail *
Telephone number (no spaces or dashes) *
Date of Birth * DD / MM / YYYY
Gender *
Full Address (Address, Apt./Suite #, City, State, ZIP) *
ABOUT YOUR PURCHASE
Date of Purchase * DD / MM / YYYY
Brand *
Product Reference (Ex: USK BL 16909, USK HA 31535) *
Production Reference (EX: PO-B11079MFR or PO11-00082, indicated on the appliance) *
Place of Purchase *
Upload Proof of Purchase (formate: JPG, GIF, TIF, PNG) *
Do Not Fill This Out