Purchase Registration

* indicates a required field.

MR/MS

* Last Name

* First Name

* Address

* City

* State

* Zip
 
Optional Info

Phone No.

Your Age

Email:
 
Product Details

* Please Select the product you are registering

Which Chia Pet/Head do you have?

This Chia was :

Chia Gourmet Herb Garden was:

Sylvester Cat Grass Planter was:

The Clapper was :

The Clapper Plus was :

Classic Pen set was

The Ove Glove was:

If it was a gift, purchaser is :

Who purchased Ignite-O Fire Starter Packets

Who purchased Creosote Sweeping Log?

Their age:

I own:

What aspects of the Chia Obama do you like? (Check all that apply)

Will you display your Chia Obama when it is not growing Chia?

Please describe other:

Who else/ what else would you like added to the Proud to be American collection as a Chia?

Please describe other:

What kind of wood burning appliances are used in your home?

If other, please describe:

How many fireplaces with glass doors?

How many woodstoves?

How many open Fireplaces?

How many fireplace inserts?

Please describe other:

In your wood burning appliance, do you usually use:

When do you normally start using your wood burning appliance?

When do you normally stop using your wood burning appliance?

How often do you have your chimney swept?

If you get your chimney swept do you:

Please describe other:

have you ever used Creosote Sweeping Log before?

If yes, how many years have you used Creosote Sweeping log?

How many times per year do you burn Creosote Sweeping Log?

What are your three most important features of the Creosote Sweeping Log

Order of importance: 1= most important, 2=second most important, 3 =third most

Where did you purchase the Creosote Sweeping log?

What are you using Ignite-O Fire Starter for?: (Check all that apply)

Please describe other:

What have you used in the past?

What are the most important feauture on Ignite-O Fire Starter? (1 = most important, 2= second most important, 3= third most important)

Order of importance:

Would you recommend Ignite-O Fire Starter to a freind?

Which features of Fast Fit Ironing Board Cover appeal to you?: (Check all that apply)

How long has it been since you replaced your ironing board cover?

How often do you iron?

What do you iron most?: ( Check top three)

Which features of The Ove Glove are important to you?: (Choose up to three)

Please describe other:

Which of the following do you think you will use your Ove Glove for?: (Check all that apply)

Did you already own an Ove Glove?

Would you consider purchasing a second Ove Glove?

Would you recommend Ove Glove to a friend?

If received as a gift, what is the relationship of the giver to you?

If received as a gift, what is the relationship of the giver to you?

Which appliances will you connect to The Clapper Plus?

Which features of The Clapper Plus appeal to you?: (Choose up to three)

Which features of The Classic Pen Set appeal to you?: (Choose up to three)

Which writing instrumentdo you like the best?

Which writing instrument do you use the most?

How will you use the remote control?

Would you be interested if additional remote controls (To activate this Clapper Plus ) were available?

With The Clapper Plus you can operate appliances by clapping or with your remote control. Please indicate which statement is most true for you.

Which appliances will be used with The Clapper?

Please describe other:

Which features of The Clapper are important to you?: (Choose up to three)

Where did you hear about The Clapper?

Please describe other:

Where did you buy The Clapper?

How many indoor cats do you have?:

If received as a gift, what is the relationship of the giver to you?

If received as a gift, why did the giver choose a Chia Pet for you?: (Check all that apply)

Please describe other:

If bought for myself, why did you purchase this Chia Pet?: (Check all that apply)

How many outdoor cats do you have?:

Has your cat eaten grass before?

What do you like about the Chia Sylvester Cat Grass Planter? : (Check all that apply)

My favorite herb(s) are: (Choose up to three)

Other herb:

Please indicate any plants you have grown:

Which aspect(s) of Chia Gourmet Herb Garden appeal to you most?: (Choose up to three)

Please rate your satisfaction level with our product (1 - 10, 10 being the best)

Will you purchase Ignite-O Fire Starter again?

Any comments or improvements on our product?

What firestarter do you usually use to start a fire?

Please describe other:

Your satisfaction with Ignite-O Fire Starter?; (1 - 10 , 10 being best)

Would you purchase Ignite-O Fire Starter ?

What did you use the Bonus Ignite-O Fire Starter for?

Please describe other: