Black & Decker Appliances

Appliances & Housewares

Storage

Cooking

REGISTER NOW TO:

Free Shipping
For registering your product you will receive free shipping on your next purchase through
Black & Decker's® Household Products on-line store.

Protect Your Product
By completing this form, we will have your purchase information on file in the event we need to contact you, if you have questions regarding your purchase, or if for some reason you have to return your product.

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By submitting this form, you are automatically entered into the for a chance to win $5,000, $25,000 or even $50,000! Thank you for choosing .
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We like to get to know the people who buy our products. Our research department
will use your answers to suggest better ways for us to do business.

The information collected on this product registration card applies only to this
Black & Decker® appliance and is governed by Applica Consumer Products, Inc.

Name & Address:

* Title Mr. Mrs. Ms. Miss
* First Name	Initial	* Last Name

* Street	Apt. No.	* City

* State/Province	* Zip/Postal Code

* E-mail Address

Telephone Number: ( ) -

Your date of birth:

Marital Status: Married Single Partnered

Model number:

Example: TCM411 (See catalog number on bottom of product.)

Date of purchase:

Name of store where purchased:

Was this product:

Purchased for your own use?
Received as a gift?
Received as a wedding gift?

If a wedding gift, was it listed on a bridal registry?

Yes

Date code:

Example: 9932 (See numbers on prongs of the plug.)

Price paid (excluding sales tax): $ .00

What three factors most influenced your decision to purchase this product? (check only 3)

Brand reputation
Store display
Advertising
Friend/Relative
Price

Style/Appearance
Quality/Durability
Product features
Warranty
Other

If applicable, please tell us about your online shopping/browsing experiences:
A. Have you ever purchased a product online?

Yes No

B. Do you browse online, but then make the purchase at a retail store?

Yes No

C. Do credit card protection issues prevent you from purchasing online?

Yes No

D. Would you call an 800# shown online to make a purchase?

Yes No

When did you decide on this purchase?

Received as a gift
Before coming into the store
While in the store

Not including yourself, what is the GENDER and AGE (in years) of children
and other adults living in your household?

No one else in household			Child under 1 year
1.	Male	Female	Age (in yrs):
2.	Male	Female	Age (in yrs):
3.	Male	Female	Age (in yrs):
4.	Male	Female	Age (in yrs):

Occupation: (check all that apply)

	You	Spouse

Professional/Technical

Upper Management/Executive

Middle Management

Sales/Marketing

Clerical/Service Worker

Tradesman/Machine Operator/Laborer

Are you or your spouse:

	You	Spouse

A Homemaker?

Retired?

A Student?

Self Employed/Business Owner?

Working from a Home Office?

In the Military?

A Veteran?

Which group describes your annual family income?

Under $15,000
$15,000-$19,999
$20,000-$29,999
$30,000-$39,999
$40,000-$49,999

$50,000-$59,999
$60,000-$74,999
$75,000-$99,999
$100,000-$124,999
$125,000-$149,999

$150,000-$174,999
$175,000-$199,999
$200,000-$249,999
$250,000 & over

Level of education: (select highest level completed)

Completed High School

Completed College

Completed Graduate School

Which credit cards do you use regularly?

American Express, Diners Club
MasterCard, Visa, Discover

Department Store, Oil Company, etc.
Do not use credit cards

For your primary residence, do you:

Own? Rent?

How recently did you move into your current residence?

Within 30 days
Within 1-3 months
Within 4-6 months 7 to 12 months ago
Have not moved in the last 12 months

Which of the following do you plan to do within the next 1-6 or 7-12 months?
(select all that apply)

	1-6 Months	7-12 Months

Buy/Lease a New Vehicle

Buy/Lease a Used Vehicle

Please check all that apply to your household.

Shop by Catalog/Mail
Shop via the Internet
Member of Frequent Flyer Program
Donate to Charitable Causes
Own a Compact Disc Player
Have a Dog

Have a Cat
Own a Wireless/Cellular Phone
Speak Spanish
Own an Apple/Macintosh Computer
Own a CD-ROM Drive

To help us understand our customers' lifestyles, please indicate the interests
and activities in which you or your spouse enjoy participating on a regular basis.

01. Bicycling
02. Golf
03. Physical Fitness/Exercise
04. Running/Jogging
05. Snow Skiing
06. Tennis
07. Camping/Hiking
08. Fishing
09. Hunting/Shooting
10. Powerboating
11. Sailing
12. Grandchildren
13. Needlework/Knitting
14. Sewing
15. Flower Gardening
16. Vegetable Gardening
17. Crafts
18. Buy Prerecorded Videos
19. Automotive Work
20. Electronics
21. Home Workshop/Do-It-Yourself
22. Recreation Vehicles (RVs)
23. Listen to Records/Tapes/CDs
24. Avid Book Reading
25. Bible/Devotional Reading
26. Health/Natural Foods

27. Photography
28. Cultural/Arts Events
29. Fashion Clothing
30. Art/Antique Collecting
31. Foreign Travel
32. Cruise Ship Vacations
33. Travel in USA
34. Gourmet Cooking/Fine Foods
35. Wines
36. Stamp/Coin Collecting
37. Collectibles
38. Our Nation’s Heritage
39. Real Estate Investments
40. Stocks/Bond Investments
41. Contests/Sweepstakes
42. Casino Gambling
43. Science Fiction
44. Wildlife/Environmental Issues
45. Dieting/Weight Control
46. Science/New Technology
47. Self-Improvement
48. Walking for Health
49. Watching Sports on TV
50. Home Video Recording
51. Moneymaking Opportunities

Using the numbers in the above list, please indicate your 3 most important activities:

To submit this registration, press this button:

To clear the form, press this button:

Failure to submit this registration will not diminish your warranty rights.

Click here to see our privacy policy and set your preferences.

is a trademark of The Black & Decker Corporation, Towson, Maryland, USA.

Your Privacy Rights
This statement discloses the privacy practices of this Product Registration website.

We believe you should know:

1. What information this site gathers about you

2. What this site does with the information it tracks

3. With whom this site shares the information it gathers

We collect personal information about our users only during product registration. We do not use cookie technology to track your movements.

We respect your right to privacy. As part of the entry process, we give you the opportunity to decline to receive any communications from other parties to whom we may provide such information.

The data we collect is used in the aggregate to give us demographic information about the entire audience registering their products. We use this to understand that audience and to improve our offerings to you, our customers.

The personal information you provide - name, address, etc. - allows us to inform you of additional special offers which may be forthcoming, and to send you coupons, or notify you of products and services of our affiliates that relate directly to your specific interests, hobbies or other information you have given.

Security

All data is stored in a highly secure database with state of the art backup and firewall technologies. It is not accessible to any unauthorized parties. This means that your information is kept safe, and is only disclosed to selected third parties to provide you with valuable information and special offers.
I do not want to receive coupons, mailings, or other special offers

To submit this registration, press this button:
If you have questions or concerns about this site, our privacy policies, data use, or wish to change your options, click here.

Black & Decker® and plus Black & Decker® are registered trademarks of The Black & Decker Corporation (Towson, MD); used under license by Applica Consumer Products, Inc. To review Applica's Corporate Privacy Policy, click here.