Extended Warranty Application

To Apply for An extended Warranty

Thank you for registering your product . By completing the following form your warranty will be extended to 3 years. Extended Warranty is only available on certain ranges of Cleaver Scientific branded products and not partner products such as Consort. To be Valid, the extended warranty my be applied for within 1 month of purchase date.
Product Serial number **

Can be found on your products
Product Stock Code*

Can be found on your products
Date of Purchase*
MM slash DD slash YYYY
Where was this product purchased?*
Name*
Salutation First Last
Job Title / Position*
Company*
Email*
Phone
Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
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Name*
First Last
Email*
Company/Institute*
Phone Number
Interests*
- Quarterly Newsletter
- Special Offers
- Company Updates
- New Product Information
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Date
DD slash MM slash YYYY
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Customer Description