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PRODUCT REGISTRATION
We at Century Furniture thank you for purchasing our furniture. Your retailer can assist you in many areas. We would, however, like to know more about you. Therefore, we ask you to complete the following questionnaire and register your purchase with us. Please note that your responses will be used for our information purposes only. No names will be sold to outside mailing companies.
REQUIRED FIELDS IN RED
FIRST NAME   LAST NAME  
ADDRESS 1   ADDRESS 2
CITY   STATE    ZIP      
EMAIL
* PLEASE PROVIDE YOUR EMAIL ADDRESS IF YOU WOULD LIKE TO OPT-IN TO RECEIVE INFORMATION ABOUT OUR NEW PRODUCTS, DESIGN TRENDS, OR PROMOTIONAL OFFERS THAT WE MAY PROVIDE IN THE FUTURE. 		OCCUPATION
YOU MAY RECORD UP TO 6 ITEM NUMBERS FROM THE STICKERS INCLUDED ON ANY PRODUCT REGISTRATION CARDS YOU RECEIVED.
THESE CAN ALSO BE FOUND ON THE SALES RECEIPT, THE BACK OR BOTTOM OF YOUR NEW FURNITURE, OR ON THE DECK LABEL OF YOUR NEW UPHOLSTERY ITEM.
 
 
RETAILER/DESIGNER PURCHASED DATE
CITY STATE    ZIP  

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