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Register your Alwaysfreshh2o product here!

* Mr. Ms. Mrs. Miss
* First Name: Initial: * Last Name:
* Street:
Street:
* City: * State: * ZIP Code:
Telephone: * Email:

Fill in the details of the Alwaysfreshh2o product you purchased.
Price paid, excluding tax and installation costs: $.00
Date of Purchase:

Which Alwaysfreshh2o product did you purchase?
Select product here:
Or if your product is not in this list, type the product name here:

Where was this product purchased?
Dealer Name:
City: State:
Or if your dealer is in this list, please select the dealer here:

Which best describes the store from which this product was purchased?
Appliance Store
Kitchen & Bath Showroom
Plumbing Supply or Plumbing Contractor
Internet
Water Treatment Dealer
Other Please describe if not listed:

Is this your first Alwaysfreshh2o purchase? YES   NO

Number of people in your household enjoying your Alwaysfreshh2o Drinking Water System?

This system is connected to (indicate all connections):
Separate kitchen filtered water faucet Plumbed-in coffee maker Refrigerator chilled water dispenser
Existing kitchen water faucet Refrigerator icemaker Under counter water chiller
Instant hot water dispenser Under counter icemaker  

What influenced you most to buy a filter at this time? (Choose up to three):
To improve taste Medical / health reasons Remodeled kitchen
To eliminate odors New baby Moved to new home / apt.
To reduce chemicals / impurities Recent water quality concerns Other:

Would you be interested in receiving a reminder to replace your filter via email?
YES   NO

Would you be interested an automatic shipment program that would ensure you high quality water, and saves you time and money?
YES   NO

Would you be interested in receiving information on other health/environmental offers via email?
YES   NO

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