Template 17

Contact Information
Courtesy:	Mr. Mrs. Ms. Miss
First Name:		Initial:
Last Name:
Street Address:		Apt. No.
City		State
Zip Code: (USA)		Country:
Email Address:
Product Information		The serial number is located on the back of the StudyBuddy as shown here.
PHOTOSONIX Model:	StudyBuddy
Serial Number
Purchased From:		Did you purchase online?
Date of Purchase:	Month Day Year
How did you hear about PHOTOSONIX products:
What were the most important factors in choosing this PHOTOSONIX product? (Select up to 3) (To select more than one option, hold down the "Ctrl" key and use your mouse to select options.)
Other:
Do you own a personal computer?	Yes No



Please enter any other comments here:
Thank you for your interest in the MindMoves® StudyBuddy.

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