Name ____________________________________________________________________________________
Address __________________________________________________________________________________
City __________________________
Sex: MALE
FEMALE
Occupation: Professional/Management
Unemployed
Other (please specify) __________________________________________________________
Which factor most influenced your decision to purchase this product? Store display
Retailer recommendation
Other (please specify)______________________________________________________________________
Pump used for:
Statuary
Check Laguna product purchased:
Rolf C. Hagen (U.K.) Ltd. California Dr. Whitwood Industrial Estate, Castleford, West Yorkshire WF10-5QH
WARRANTY REGISTRATION CARD
Return to validate your guarantee
Age group: 16 or less
Clerical
Recommendation of a friend or relative
Other/ Specify ________________________________________________
STATUARY PUMP 1
PT-300
U . K .
17-35
Manual
Student
STATUARY PUMP 2
36-60
Over 60
Retired
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Received as a gift
STATUARY PUMP 3
PT-305
PT-310