Product Registration.

To ensure your warranty is honored, please fill out !

Registration for United States
1. *First Name Middle Initial *Last Name
 
*Home Address *City
*State
*Zip Code
*Phone Number Email
Gender: Male Female
Date of birth    Month: Year:
Marital Status:Married Single
2. What ethnicity best describes yourself Your highest level of education completed
OccupationHousehold Income
3. Which of the following statements best describes you?:


4A. Please select the product type of the first A.C. Shockwave product you are registering:
*
Please select the specific model number:
Serial Number:


If your purchased more than one A.C. Shockwave component, please use 4B. and 4C. below to register.
If not, please skip to question #5.

4B.  Please select the product type of the second A.C. Shockwave product you are registering:

Please select the specific model number:
Serial Number:


4C.  Please select the product type of the third A.C. Shockwave product you are registering:

Please select the specific model number:

Serial Number:


5.  Date of purchase of A.C. Shockwave component(s).

6.  Store type where the purchase was made:

7.  Please tell us about the Vehicle you installed the A.C. Shockwave component(s) into:
 
Does not apply

8.  How was this vehicle purchased?
Buy
Lease

9.  What was the purpose of buying this unit:

10A.  If a replacement, what was the previous brand being replaced?

11.  Have you purchased A.C. Shockwave products before?
Yes
No

12.  When you purchased this A.C. Shockwave unit, did you compare it with other brands?
Yes   Which brands?:
No

13.  Comments for the above A.C. Shockwave products:

A.C. Shockwave, Inc., will not sell or disclose any information gathered from your profile to anyone outside of A.C. shockwave, Inc. Information collected regarding visitors to this site is used for internal purposes only.

Periodically, A.C. shockwave, Inc. would like to send you information on new products and promotions, or surveys on our products. If you are NOT interested in receiving future information from A.C. shockwave, Inc., please check the box.