Product Registration Form
Salutation:
[select]
Mr.
Ms.
Mrs.
Miss
Street:
First Name:
Last Name:
Prov/State:
Phone:
Postal Code/Zip:
Email Address:
Country:
Product Information
Turbine:
[select]
1500w
3500w
N/A
serial #:
* contact your dealer if you do not know your serial #
Inverter:
[select]
1500i
4000i
N/A
serial #:
Battery Charger:
[select]
1600B
4000B
N/A
serial #:
Tower:
[select]
49t (lattice)
48t (monopole)
70t (guy)
N/A
Installed At:
[select]
Farm
Acreage
Town
Business
Date of Purchase:
Date Installed:
Where was the system purchased?
Dealer Name:
City:
Price:
Prov/State:
Where did you first learn about this product?
[select]
Website
Magazine
Newspaper
Friend/Family
Other, explain:
What influenced you to purchase this product?
[select]
Environment
Rising Energy Costs
Off grid application
Other, explain:
Do you have any other energy conservation systems in place?
[select]
Geothermal
Solar
No
Other, explain:
Optional Questions - these are not mandatory for product registration, but we would appreciate your input:
Highest level of education:
[select]
Unfinished highschool
Highschool
Post-secondary/trade school
Unfinished bachelor's
Bachelor's degree
More than one bachelor's degree
Master's / PhD
Date of Birth: year
Which group describes your annual family income:
[select]
under $29,000
$30,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000 - $149,999
$150,000 +
*Please note that you are submitting data on an unencrypted form. Any data that you enter in this form will be transmitted in plain text. If you send unencrypted data to Raum Energy Inc. then there is a risk that others might be able to read or capture the contents of your email. If you are not prepared to accept this risk, we suggest that you contact us by an alternative means.