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Street Name *
PO Box Rural Route No.
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Province *
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Product Information

Model *
Serial No. * (14 or 16 digits)
Date of Purchase *
Purchase Price * $ (e.g. $199.99, dollars and cents before tax)

How did you first become aware of this product? *

  Received as a Gift
  In store Demo
  Magazine Article
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Check the two (2) most important reasons influencing your purchase of this Cuisinart® product: *

  Received as a Gift
  Special Offer
  Ease of Operation
  Product Features
  Style / Appearance
  Quality / Durability
  Cuisinart® Reputation
  Value for Price
  Recommendation of Friend/Family
  Recommendation of Salesperson
  Prior experience with Cuisinart®
  Only Brand Available
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