Bicycle Registration Form

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Welcome! You have reached the product registration page at Biria.com. Registering your Biria bicycle will assure you that you will be notified of any warranty issues concerning this bicycle. It also serves as proof of ownership.

If you have a specific question and expect to receive a reply, please email it to info@biria.com. The comment box below is for your general comments on our products.

First Name *

Middle Initial

Last Name *

Street Address

City

State/Province

Zip Code

Country

Email Address

Telephone

Gender

Male

Female

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Birthday

YYYY

Place of Purchase

Authorized Dealer

Other:

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Date of Purchase

YYYY

Bike Shop Name

Bicycle Color

Bicycle Model

Serial Number

Overall Satisfaction With The Product

Very Satisfied

Satisfied

It's Okay!

Disatisfied

Very Disatisfied

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How did you first become aware of Biria bicycles? Check all that applies

Bike Shop

Internet

Word of Mouth

Saw Someone Else Riding It

Other:

May we contact you via email for the latest Biria news and special offers?

Yes

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Comments

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