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HELIOS LABS PRODUCT REGISTRATION
Please take a moment to register your product with us.

Customer Information

First Name:		Last Name:
Street:		Apt:
City:		State/Province:
Country:		Zip/Postal Code:
Email address:

Date of birth:

Month

Day

Year

Marital Status:

Married

Single

Purchase Information

Product Model:
Serial Number:

Date of purchase:

Month

Day

Year

Place of purchase:

Which TV display model are you using with your player?

Manufacturer:

Model:

What video configuration do you use?

HDMI

Component

S-Video

Composite

Other

(please specify:

)

What video resolution do you use?

1080p

1080i

720p

480p/576p

480i/576i

Other

(please specify:

)

What audio configuration do you use?

Stereo

5.1 Surround

Digital (coaxial)

Digital (optical)

Other

(please specify:

)

Please describe your network configuration:

Wired

Wireless

None

Other

(please specify:

)

What kind of internet connection do you use in your home?

Cable

DSL

Dial-up

Satellite

Fiber

Other

(please specify:

)

Where did you first hear about your new Helios product?

Friends/Family

Internet

Magazine review

Dealer recommendation

Other

(please specify:

)

On a scale of 1 to 9, how easy was it to set up your new Helios product?

Easy

Difficult

Additional information:

What is your current occupation?

Arts/Media:	Education:	Homemaker:
Management:	Military:	Professional/Technical:
Retired:	Sales/Marketing:	Self-employed:
Student:	Trade:	Unemployed:

Other

(please specify:

)

Which group best describes your combined household income?

Less than $40,000

$40,000 - $75,000

$75,000 - $100,000

More than $100,000

Comments/Additional information:

Thank you for registering your product with us!
If you have any questions, please contact us at info@helios-labs.com.