Zap ELECTRIC SCOOTER Owner's Manual download pdf (Page 21)

Please take a couple of minutes to fill out your registration card. This informal

survey will aid us in providing our customers with the best possible product.

Name: ______________________________ Address: _____________________________________

City:_______________________________ State:______ Country:____________ Zip:____________

Phone: (Home)_______________________________ (Work)________________________________

Purchase Date: ________________ Purchased From: _____________________________________

Serial Number (Stamped on ZAPPY motor guard. Flip ZAPPY over to read serial number):

_________________________________________________________________________________

Age:______ Sex:______ Occupation:__________________________________________________

Is this your first Electric Vehicle?_______________________________________________________

I use my ZAPPY for: Commuting Recreation Work Fun Shopping Exercise Environment

If work, what application_________________________________________

Other_________________________________________ My typical length of ride is: ________miles

Where did you hear about our product? Friend Relative Associate Internet Show News Article Dealer

Ad (where)______________________________ Other_____________________________________

Are you interested in ZAP Shareholder information? (Our stock symbol NASDAQ:ZAPP)

Yes No

Do you use the internet?

Yes No If so, what is your E-mail address? ___________________________________

Favorite Magazines:

1. ________________________ 2. ________________________ 3. ________________________

Favorite TV Shows:

1. ________________________ 2. ________________________ 3. ________________________

Are you interested in a ZAP Store? Are you interested in selling ZAPs?

Yes No Yes No

Are you interested in assisting us in: (check applicable)

Marketing _______ Public Relations _______

Dealer Information _______ A ZAP Franchise _______

Comments:________________________________________________________________________

_________________________________________________________________________________

WARRANTY CARD: Please complete both sides and return within 10 days of purchase.

THANK YOU!

Visit ZAP at our Web Site!

ZAPWORLD.COM

...a better way

Earn $50 for articles!

(Call ZAP's PR Department for details)

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Zap ELECTRIC SCOOTER Owner's Manual Page 21