Metari: Product Registration


	Product Registration

* = Required fields

	Mr. Mrs. Ms. Miss

^*	First Name:	Initial:

^*	Last Name:

^*	Street Address:

^*	City:	^State: ^Zip:

	Phone Number:	( ) -

	Email Address:

	Date Of Purchase:	Month: Day: Year:

	Store Name:

	Store Location:	City: State:

^*	Why did you purchase the Metari Coffee Meter?

	Your own use		Given to you as a gift
	To be given as a gift		Other

^*	Where will the Metari Coffee Meter be used?

	At home		At work
	Other

^*	How did you first learn about the Metari Coffee Meter?

	Catalog		Friend/Colleague	Product Package
	Radio		Product on Display	In-Store Display Sign
	Sales Representative		Newspaper Article	Newspaper Ad
	Magazine Article		Magazine Ad	Internet
	Other

^*	Would you recommend this product to your friends?

	Yes	No

^*	What kind of coffee do you like?

	Regular Drip Coffee		Espresso	Cappuccino
	Latte		Ice Coffee

^*	How do you drink your coffee?

	Black		With Cream	With Sugar
	With Sugar and Cream

^*	Where do you buy your coffee?

	Supermarket		Coffee Store	Mail Order
	Any national or local brand, please specify:

^*	What kind of coffee roast do you prefer?

	Light Roast		Medium Roast	Dark Roast
	Extremely Dark Roast

^*	Do you grind your own beans?

	Yes	No

^*	What kind of grinder do you use?

	Manual		Electric Blade Grinder	Electric Burr Grinder

^*	How much coffee does your household consume per week?

	0-1/2 pound per week		1/2-1 pound per week	More than 1 pound per week

^*	Does a tea drinker reside in your household?

	Yes	No

^*	If yes, what type of tea is used?

	Tea Bags		Loose Leaf	Both
	Other:

	Product Comments/Suggestions: