Bose 161TM - Manual (Page 15)

6
Please indicate the serial number(s) of this product
(Found on the ID label attached to your product or consult your owner's manual for the location )
Serial number(s)
Where was product purchased
1. □ Bose'® 1-800 number
2. □ Bose Web site
3. n Bose store
4. □ Retail store
Name:
City
State
5. □ Catalog
6. □ Other Web site
7. □ Other
8a
Do you own any other Bose products?
8b Which ones?
1. □ Lifestyle'^' system
l . j Y e s 2 . _ N o
Headset
2. □ Wave® radio/Acoustic Wave- system 6 U Other Bose speakers
3. □ Automobile sound system
4. □ Acoustimass® speakers
7 G Other
9 Date of your birth: (month/day/year)
10 Including yourself, what is the total number of people living in your household?
(Example:
Oh 02.03, 04 )
11 Date of birth (month/year) of the gtfM adults and children in your household.
Male Female
1.G 2.G
1.G 2.G
Month
Month
Year
Year
Male Female
1 G 2,^
1.G 2. G
Female
Month
Month
Year
Yeat
12
Your gender: 1 G Male 2
13 Your marital status: 1 G Married 2, G Single
14 For your primary residence, do you: 1. G Own 2 G Rent