|
|
|
|
|
Please note this form is ONLY for Starter Kits.
If you would like to register a Warranty Card for other items please click here.
The fields with a red ( * ) are required
|
|
|
Title :
|
|
|
|
First name : *
|
|
|
|
Last name : *
|
|
|
|
Address :*
|
|
|
|
Apartment:
|
|
|
|
City:*
|
|
|
|
Shire / County :*
|
|
|
|
Zip :*
|
|
|
|
Country : *
|
UK
|
|
|
Telephone: *
|
|
|
|
Email : *
|
|
|
|
Starter Kit Art. No. : *
|
|
|
|
How did you obtain this Starter Kit? *
|
If other specify:
|
|
|
Name of store where item was purchased :
|
|
|
|
Location of store (city) :
|
|
|
|
Location of store (shire / county) :
|
|
|
|
My household includes (please check off one or more):
|
|
|
Aquarium(s)
|
Please specify:
Freshwater
Saltwater
Planted
|
|
|
Bird(s)
|
Please specify:
|
|
|
Cat(s)
|
|
|
|
Dog(s)
|
|
|
|
Ferret(s)
|
|
|
|
Gerbil(s)
|
|
|
|
Hamster(s)
|
|
|
|
Pond(s)
|
|
|
|
Rabbit(s)
|
|
|
|
Reptile(s)
|
Please specify:
|
|
|
Other
|
Please specify:
|
|
|
|
|
|
Occasionally Hagen will be releasing product and other information.
Would you like to be updated on : new product releases
|
|
|
press release
|
|
|
If Yes, what is your language of preference?
*
|
|
|
|