Bacharach INSIGHT Free B-Smart Upgrade Form

Thank you for purchasing a Fyrite INSIGHT®.

The FREEDOM UPGRADE gives you FREE calibration coverage with a 3-year
B-Smart® Sensor Exchange Program for each Fyrite® INSIGHT® you purchase.

Please register your Fyrite® INSIGHT® purchase by completing the form below to activate your B-Smart® coverage. *Note required fields. Only ONE instrument can be registered per each form. A Bacharach associate may contact you if additional details are needed to start your free coverage.

If your invoice or receipt (proof of purchase) is in electronic format, you can attach it to the form below. For paper receipts/invoices, you MUST fax to 724-334-5728 OR mail to: BACHARACH FREEDOM UPGRADE, 621 Hunt Valley Circle, New Kensington, PA 15068, USA. Call our Customer Service department at 800-736-4666 if you have questions.

*Company Name:
*First Name:
*Last Name:
*Email Address:
*Address (cannot be a PO box):
Apartment or Suite #:
*City:
*State or Province:
Country:
*Telephone #:
*Promotion Code #
*Instrument Type:
*Provide Serial Number from Instrument (ex. SR1001):
*Name of Distributor Where Product Purchased:
If you have an electronic copy of your invoice or receipt, you may attach it here. Otherwise, please fax or mail to the information provided at the top of this form.
*Amount Paid (excluding taxes and shipping):
*Product Purchase Date:
*Check Month of product's first use:
*Enter the date you want your B-Smart coverage to start (recommended: 9 months after 1st use of the instrument).

You are receiving this message because you have previously provided your email address to Bacharach as a customer, professional colleague, partner or associate. If you have received this message in error or do not wish to be included in our electronic newsletter or special events distribution, please reply to this email with UNSUBSCRIBE in the subject line.