Thank you for choosing to join the Senseo® family. Please fill out the information below to be part of the elite group of Coffee Drinkers who enjoy their daily coffee fixes with a consistent and mild after taste in every cup. As a member of our community, you'll receive news, discounts and special offers. Register your machine, share your experience in our facebook page and sit back and enjoy great tasting and freshly brewed coffee every time with Senseo®.

Tell us about yourself:

* First Name:	* Last Name:
* Email:	* Retype Email:
Gender: Female   Male	Age Range: Select 18-24 25-34 35-44 45-54 55-64 65-74 75 years or older
Address:	Address (cont.):
City:	State: Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington, D.C. West Virginia Wisconson Wyoming Zip: Province: Select Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Zip:
Phone: example (###-###-####)	Country: Select United States Canada
Which Senseo® products are you interested in? (check all that apply) Regular Coffee Decaf Coffee Flavored Coffee	* How many coffee drinkers are in your household? None One Two More than two
* My Single Serve Coffee Machine is a: Gift Purchase Promotional offer Do not own a Senseo® machine	* I would be willing to share my opinions as part of a Senseo® market research study Yes No
* I use the following Senseo® Machine Model:  (model number is located on the bottom of your machine) Base HD7810/SL7810 Supreme HD7832/SL7832 Hamilton Beach, Personal Cup (49970) Hamilton Beach, Stay or Go® Personal Cup™ (49990) Other Do not own a Single Serve machine

Join Club Senseo®:

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Yes, I would like to receive special offers, promotions and news from Senseo® No, thanks

Register Your Machine (optional):

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Yes No, thanks I do not own a machine

Product code: (numeric found on the bottom right corner of sticker on the bottom of the machine)  Click here for an example.

Place of Purchase:

Purchase date: Month January February March April May June July August September October November December Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2007 2008 2009 2010 2011 2012 City: Province: Select Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon State: Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington, D.C. West Virginia Wisconson Wyoming

By clicking, you agree that you have read the following: Philips and the Sara Lee Corporation do not rent, sell or otherwise distribute consumer information. We make every effort to ensure that any data collected is accurate, timely and secure. Must be at least 18 years old to register.

You acknowledge and have read the terms of the above legal information.

Most of our communication is over e-mail, so be sure to add our address, newsletter@clubsenseo.com to your safe contact list.