PRODUCT REGISTRATION FORM
Note: The information you have provided will remain confidential and not be sold or distributed beyond our control.
First Name
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Last Name
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City
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State
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Zip Code
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Country
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Email
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Bike Brand
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Select Brand
Fuji Bikes
SE Bikes
Kestrel Bicycles
Breezer Bikes
Tuesday Cycles
Bike Model
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Bike Size
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Serial No.
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Store Where Purchased
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Date Of Purchase
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(example: mm/dd/yyyy)
Purchase Price
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(Mention Currency Type)
How did you become aware of this bike model?
In-store display
Professional team/athlete
Print ad
Online ad
Friend/relative
Store salesperson
Received as gift
Other
Select the most important factors influenced your selection of this bicycle:
Brand’s reputation
Price
Style/appearance
Lightweight
Durability
Special Features
Warranty
Previously owned this brand
Friend’s recommendation
Salesperson’s recommendation
Other
What other types of bikes do you own or are interested in purchasing? (check all that apply)
Road
Triathlon
Mountain
BMX
Single speed
Touring
Hybrid
Kids
Commuting/Transportation
Other
What other bike model did you most heavily consider before this purchase:
