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MANUAL DE INSTRUCC I O NE S
Model Numbers / No. de Modelos:
ALL REFRIGERATOR
(REFRIGERADOR)
INSTRUCTION MANUAL
BCA4421WL / BCA4422BL /BCA4499SSL
BCA4421WL / BCA4422BL BCA4499SSL
BEFORE USE, PLEASE READ AND FOLLOW ALL SAFETY RULES AND OPERATING
INSTRUCTIONS.
La sección en español empieza en la página 16.
Avanti Products has a policy of continuous improvement on its products and reserves the right to change materials and
specifications without notice.
Avanti Products, A Division of The Mackle Co ., Inc.
P.O. Box 520604 - Miami, Florida 33152
www.avantiproducts.com
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TABLE OF CONTENTS
Refrigerator Safety 4
Important Safeguides 5
Help Us Help You … 6
Parts and Features 7 – 8
Important Safety Instructions 9
Installation Instructions 9
Before Using Your Appliance 9
Installation of Your Appliance 9
Electric al Connection 10
Extension Cord 10
Reversing the Door Swing of Your Appliance 10
Operating Your Appliance 11
Setting the Temperature Control 11
Interior Light 11
Door Lock 11
Care and Maintenance 11
Cleaning Your Appliance 11
Power Failure 12
Vacation Time 12
Moving Your Appliance 12
Energy Saving Tips 12
Troubleshooting Guide 13
Service for Your Appliance 14
Wiring Diagram 14
Your Avanti Products Warranty 15
Instrucciones en Español 16 – 17
Registration Information and Registration Card 19
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REFRIGERATOR SAFETY
Your safety and the safety of others are very important.
We have provided many important safety messages in this manual for your appliance. Always read
and obey all safety messages.
This is the Safety Alert Symbol. This symbol alerts you to potential hazards that
can kill or injure you and others. All safety messages will follow the Safety
Alert Symbol and either the words” DANGER”, “WARNING” o r “CAUTION”.
Danger means that failure to heed this
safety statement may result in severe
personal injury or death.
Warning means that failure to heed this
safety statement may result in extensive
product damage, serious personal injury, or
death.
Caution means that failure to heed this
safety statement may result in minor or
moderate personal injury, property or
equipment damage.
All safety messages will alert to know what potential hazard is, tell you how to reduce the chance of
injury, and let you know what can happen if the ins tructions are not followed.
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IMPORTANT SAFEGUIDES
Before the refrigerator is used, it must be properly positioned and installed as
described in this manual, so read the manual carefully. To reduce the risk of fire,
electrical shock or injury when using the refrigerator, follow basic precaution,
including the following:
• Plug into a grounded 3-prong outlet, do not remove grounding prong, do not use an adapter, and
do not use an extension cord.
• Replace all panels before operating.
• It is recommended that a separate circuit, serving only your refrigerator be provided. Use
receptacles that cannot be turned off by a switch or pull chain.
• Never clean refrigerator parts with flammable fluids. These fumes can create a fire hazard or
explosion. And do not store or use gasoline or other flammable vapors and liquids in the vic i nity of
this or any other appliance. The fumes can create a fire hazard o r explosion.
• Before proceeding with cleaning and maintenance operations, make sure the power line of the
unit is disconnected.
• Do not connect or disconnect the electric plug when your hands are wet.
• Unplug the refrigerator or disconnect power before cleaning or servicing. Failure to do so can
result in electrical shock or death.
• Do not attempt to repair or replace any part of your refrigerator unless it is specifically
recommended in this manual. All other servicing should be referred to a qualified technician.
FOLLOW WARNING CALL OUTS BELOW ONLY WHEN APPLICABLE TO YOUR MODEL
• Use two or more people to move and install refrigerator. Failure to do so can result in back or
other inju ry.
• To ensure proper ventilation for your refrigerator, the front of the unit must be completely
unobstructed. Choose a well-ventilated area with t emperatures above 60°F (16
90°F (32°C). This unit must be installed in an area protected from the element, such as wind, rain,
water spray or drips.
• The refrigerator should not be located next to ovens, grills or other sourc es of high heat.
• The refrigerator must be installed with all electrical, water and drain connecti ons in accordance
with state and local codes. A standard electrical supply (115 V AC only, 60 Hz ), properly
grounded in accordance with the National Electrical Code and local codes and ordinances is
required.
• Do not kink or pinch the power supply cord of refrigerat or.
• The fuse (or circuit breaker) size should be 15 amperes.
• It is important for the refrigerator to be lev eled in order to work properly. You may need to make
several adjustments to level it.
• All installation must be in accordance with local plumbing code requirements.
• Make certain that the pipes are not pinched or kinked or damaged during installations.
• Check for leaks after connection.
• Never allow children to operate, play with or crawl inside the refrigerato r.
• Although the unit has been tested at the factory, due to long-term transit and storage, the first
batch of cubes must be discarded.
• Do not use solvent-based cleaning agents of abrasives on the interior. These cleaners may
damage or discolor the interior.
• Do not use this apparatus for other than its intended purpose.
°
C) and below
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HELP US HELP YOU...
Read this guide carefully.
It is intended to help you operate and maintain
your new beverage center properly.
Keep it handy to answer your questions.
If you don't understand something or you
need more assistance, please call:
Avanti Customer Service
800-220-5570
Keep proof of original purchase date (suc h as
your sales slip) with this guide to establish the
warranty period.
CAUTION:
THIS BEVERAGE CENTER IS
NOT DESIGNED FOR THE
STORAGE OF MEDICINE OR
OTHER MEDICAL PRODUCTS.
IF YOU NEED SERVICE
We're proud of our service and want you to be
pleased. If for some reason you are not happy
with the service you receive, here are some
steps to follow for further assistance.
FIRST, co ntact the people who s erviced your
beverage center. Explain why you are not
pleased. In most cases, this will solve the
problem.
Write down the model and serial numbers.
You'll find them on a plate located on the rear
outside wall of the beverage center.
Please write these numbers here:
____________________________________
Date of Purchase
____________________________________
Model Number
____________________________________
Serial Number
Use these numbers in any correspondence or
service calls concerning your beverage center.
If you received a damaged beverage center,
immediately contact the dealer (or builder) that
sold you the beverage center.
Save time and money. Before you call for
service, check the Troubleshooting Gui de. It
lists caus es of minor oper a ting problem s that
you can correct yourself.
NEXT, if you are still not pleased, write all the
details, including your telephone number, and
send it to:
Customer Service
Avanti Products
10880 NW 30 Street
Miami, FL 33172 USA
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PARTS & FEATURES
(Only for BCA4421WL and BCA4422BL)
Remark:
- Model BCA4421WL is All Refrigerator in white color.
- Model BCA4422BL is All Refrigerator in black color.
1. INTERIOR LIGHT
2. TEMPERATURE CONTROL
3. FULL WIRED SHELVES (2)
4. GLASS CRISPER LID
5. CRISPER
6. LEVELING LEGS
7. DOOR BINS
8. CAN DISPENSER
9. 2-LITER BOTTLE BIN
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PARTS & FEATURES
(Only for BCA4499SSL)
Remark:
- Model BCA4499SSL is All Refrigerator in stainless steel door with black cabinet.
1. DECORATIVE COUNTERTOP
2. INTERIOR LIGHT
3. TEMPERATURE CONTROL
4. FULL GLASS SHELVES (2)
5. GLASS CRISPER LID
6. CRISPER
7. LEVELING LEGS
8. DOOR BINS (2)
9. CAN DISPENSER
10. 2-LITER BOTTLE BIN
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IMPORTANT SAFETY INSTRUCTIONS
aWARNINGa
• Read all instructions before using the refrigerator.
• DANGER or WARNING: Risk of child entrapment.
Child entrapment and suffocation are not problems of the past. Junked or abandoned
appliances are still dangerous . . . even if they will “just sit in the garage a few days”.
• Before you throw away your old refrigerator: Take off the door. Leave the
shelves in place so that children may not easily climb inside.
• Never allow children to operate, play with, or crawl inside the appliance.
• Never clean appliance parts with flammable fluids. The fumes can create a fire
hazard or explosion.
• Do not store or use gasoline or any other flammable vapors and liquids in the vicinity
of this or any other appliance. The fumes can create a fire hazard or explosion.
-Save these instructions-
INSTALLATION INSTRUCTIONS
¾ Before Using Your Appliance
• Remove the exterior and interior packing.
• Check to be sure you have all of the following parts:
• 2 Full Wired Shelves for BCA4421WL and BCA4422BL
• 2 Full Glass Shelves for BCA4499SSL
• 2 Keys
• 1 Glass Crisper Lid
• 1 Crisper
• 1 Instructi o n M anual
• Before connecting the unit to the power source, let it stand upright for approxima tely 2 hours. This
will reduce the possibility of a malfunction in the cooling system from handling during
transportation.
• Clean the interior surface with lukewarm water using a soft cloth.
¾ Installation of Your Appliance
• This appliance is designed to be free standing installat ion only, and should not be recessed or
built-in.
• Place your appliance on a floor that is strong enough to support it when it is fully loaded. To level
your appliance, adjust the front leveling legs at the bottom of the appliance.
• Locate the appliance away from direct sunlight and sources of heat (stove, heater, radiator, etc.).
Direct sunlight may affect the acrylic coating and heat sources may increase electrical
consumption. Extreme cold ambient temperatures may also cause the unit not to perform
properly.
• Avoid locating the unit in moist areas.
• Plug the appliance into an exclusive, properly installed-grounded wall outlet. Do not under any
circumstances cut or remove the third (ground) prong from the power cord. Any questions
concerning power and/or grounding should be directed toward a certified electrician or an
authorized Avanti Products service center.
To reduce the risk of fire, electrical shock,
or injury when using your appliance, follow
these basic precautions:
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¾ Electrical Connection
Improper use of the grounded plug can result in the risk of electrical shock. If the power cord is
damaged, have it replaced by an authorized Avanti Products service center.
aWarninga
This appliance should be properly grounded for your safety. The power cord of this appliance is
equipped with a three-prong plug which mates with standard three prong wall outlets to minimize the
possibility of electrical shock.
Do not under any circumstances cut or remove the thir d ground prong from the power cord suppli ed.
For personal safety, this appliance must be properly grounded.
This appliance requires a standard 115/120 Volt AC ~/60Hz electrical ground outlet with three-prong.
Have the wall outlet and circuit checked by a qualified electrician to make sure the outlet is properly
grounded. When a standard 2-prong wall outlet is encountered, it is your responsibility and obligation
to have it replaced with a properly grounded 3-prong wall outlet.
The cord should be secured behind the appliance and not left expos ed or dangling to prevent
accidental injury.
The appliance should always be plugged into it s own individual electrical outlet which has a v oltage
rating that matches the rating label on the appliance. This provides the best performance and also
prevent overloading house wiring circuits that could cause a fire hazard from overheated. Never
unplug the appliance by pulling the power cord. Always grip the plug firmly and pull straight out from
the receptacle. Repair or replace immediately all power cords that have become frayed or otherwise
damaged. Do not use a cord that shows cracks or abrasion damage along its length or at either end.
When moving the appliance, be careful not to damage the power cord.
¾ Extension Cord
Because of potential safety hazards under certain conditions, it is strongly recommended that you do
not use an extension cord with this appliance. However, if you must use an extension cord it is
absolutely necessary that it be a UL/CUL-Listed, 3-wire grounding type appliance extension cord
having a grounding type plug and outlet and that the electrical rating of the cord be 115 volts and at
least 10 amperes.
¾ Reversing the Door Swing of Your Appliance
This appliance has the capability of the door opening from either the left or right side. The unit is
delivered to you with the door opening from the left side. Should you desire to reverse the opening
direction, please call service for reversal instructions.
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OPERATING YOUR APPLIANCE
¾ Setting the Temperature Control
• To control the internal temperature, adjust the
temperature control according to the ambient
temperature or purpose of use. The temperature
control is located on the upper right hand side of the
compartment.
• The first time you turn the unit on, set the temperature
control to “6”.
• The range of t he temperature control is from position
"OFF” to “6”. After 24 hours, adjust the temperatur e
control to the setting that best suites your needs. The
setting of “4” should be appropriate for home or off ice
use.
• To turn the unit off, turn the temperature control to "OFF”.
NOTE:
Turning the temperature control to "OFF" position stops the c ooling c ycle b ut does not s hut off the
power to the appliance.
If the unit is unplugged, power lost, or is turned off, you mus t wait 3 to 5 minutes before restarting
the unit. If you attempt to restart before this time delay, the appliance will not start.
¾ Interior Light
When you open the door the light will be ON automatically. When you close the door the light will turn
OFF automatically.
¾ Door Lock
Your unit is provided with a lock and key combination.
The keys are located inside the plastic bag that contains the User’s Guide. Insert the key into the lock
and turn it counterclockwise to unlock the door. To lock the door do the reverse o peration making
sure metal pin is engaged completely. Remove the key and place it in a secure place for safekeeping.
CARE AND MAINTENANCE
¾ Cleaning Your Appliance
• Turn the temperature control to "OFF", unplug the appliance, and remove all items including
shelves and crisper.
• Wash the inside surfaces with a warm water and baking soda solution. The solution should be
about 2 tablespoons of baking soda to a quart of water.
• Wash the shelves and crisper with a mild detergent solution.
• Wring excess water out of the sponge or cloth when cleaning area of the controls, or any
electrical parts.
• Wash the outside cabinet with warm water and mild liquid detergent. Rinse well and wipe dry with
a clean soft cloth.
CAUTION
Failure to unplug the appliance could result in electrical shock or personal injury.
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¾ Power Failure
• Most power failures are corrected within a fe w hours and should not affect the temperature of
your appliance if you minimize the number of times the door is opened. If the power is going to be
off for a longer period of time, you nee d to take the proper steps to protect your contents.
¾ Vacation Time
• Short vacations: Leave the beverage center operating during vacations of less than three
weeks.
• Long vacations: If the appliance will not be used for several months, remove all items and turn
off the appliance. Clean and dry the interior thoroughly. T o prevent odor and mold growth, leave
the door open slightly: blocking it open if necessary.
¾ Moving Your Appliance
• Remove all items.
• Securely tape down all loose items (shelves) inside your appliance.
• Turn the adjustable legs up to the base to avoid damage.
• Tape the door shut.
• Be sure the appliance stays secure in the upright position during transportation. Also protect
outside of appliance with a blanket, or similar item.
¾ Energy Saving Tips
• The unit should be located in the coolest area of the room, away from heat producing appliances,
and out of the direct sunlight.
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PROBLEMS WITH YOUR APPLIANCE?
You can solve many common problems easily, saving you the cost of a possi ble service call. Try the
suggestions below to see if you can solve the problem before calling the servicer.
TROUBLESHOOTING GUIDE
PROBLEM POSSIBLE CAUSE
Appliance does not operate.
Appliance is not cold enough. Check the temperature control setting.
Turns ON and OFF frequently. The room temperature is hotter than normal.
The light does not work.
Vibrations. Check to assure that the appliance is level.
The appliance seems to make too much noise.
The door will not close properly.
Not plugged in.
The circuit breaker tripped or a blown fuse.
The appliance temperature control is set at “OFF”
position.
External environment may require a higher
setting.
The door is opened too often.
The door is not closed completely.
The door gasket does not seal properly.
A large amount of contents has been added to
the appliance.
The door is opened too often.
The door is not closed completely.
The temperature control is not set correctly.
The door gasket does not seal properly.
Not plugged in.
The circuit breaker tripped or a blown fuse.
The bulb has burned out.
The rattling noise may come from the flow of the
refrigerant, which is normal.
As each cycle ends, you may hear gurgling
sounds caused by the flow of refrigerant in your
appliance.
Contraction and expansion of the inside walls
may cause popping and crackling noises.
The appliance is not level.
The appliance is not level.
The door was reversed and not properly installed.
The gasket is dirty.
The shelves are out of position.
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SERVICE FOR YOUR APPLIANCE
We are proud of our customer service organization and the network of professional service
technicians that provide service on your Avanti appliances. With the purchase of your Avanti
appliance, you can have the confidence that if you ever need ad ditional inf ormati on or assist ance, the
Avanti Products Customer Service team will be here for you. Just call us toll-free.
AVANTI PRODUCTS CUSTOMER SERVICES
Product Information
800-323-5029
Part Orders
800-220-5570
In-Home Repair Service
800-220-5570
Whatever your questions are about our products,
help is available.
You may order parts and accessories that will be
delivered directly to your home by personal
check, money order, Master Card, or Visa.
An Avanti Products authorized service center will
provide expert repair service, scheduled at a time
that is convenient for you. Our trained servicers
know your appliance inside and out.
WIRING DIAGRAM
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YOUR Avanti Products WARRANTY Staple your sales receipt here. Proof of
original purchase date is needed to obtain
service under warranty.
WHAT IS COVERED
LIMITED ONE-YEAR
WARRANTY
For one year from the date of
purchase by the original owner, Avanti
Products will, at its option, repair or
replace any part of the unit, which
proves to be defective in material or
workmanship under normal use.
During this period Avanti Products will
provide all parts and labor necessary
to correct such defects free of c harge,
so long as the unit has been installed
and operated in accordance with the
written instructions in this manual. In
rental or commercial use, the warranty
period is 90 days. All Avanti
Appliances of 3.5 cubic feet capacity
or less must be brought/sent to the
appliance service shop for repair.
LIMITED SECOND THROUGH
FIFTH YEAR WARRANTY
For the second through the fifth year from date
of original purchase, Avanti Products will
provide a replacement compressor free of
charge due to a failure. You are responsible
for the service labor and freight charges. In
rental or commercial use, the limited
compressor warranty is one year and nine
months. Cost to move the appliance to the
servicers’ shop and back to the user's home,
as may be required, are the user's
responsibility.
WHAT IS NOT COVERED
• Content losses of food or other, due to
spoilage.
• Incidental or consequential damages.
• Parts and labor costs for the following will
not be considered as warranty:
• Door springs, and/or frames.
• Inner door panels, door rails and/or door
supports.
• Light bulbs and/or plastic housing.
• Plastic cabinet liners.
• Punctured evaporator that voids the
warranty on the complete sealed system.
• Repairs performed by unauthorized
servicers.
• Service calls that do not involve defects in
material or workmanship such as
customer education, door reversal, or
proper installation.
• Service calls that are related to external
problems, such as abuse, misuse,
inadequate electrical power, accidents,
fire, floods, or acts of God.
• Surcharges including, but not limited to,
any after hour, weekend, or holiday
service calls, tolls, ferry trip charges, or
mileage expense for service calls to
remote areas, include the State of Alaska
• Replacement of house fuses or resetting
circuit breakers.
• Failure of the product if it is used for other
than its intended purpose.
• This warranty does not apply outside the
Continental USA.
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INSTRUCCIONES EN ESPAÑOL
INSTALACION
Retire los accesorios de empaque (plásticos protectores, cartón y tiras engomadas). Limpie el
exterior con un trapo suave y seco, y el interior con un trapo húmedo y tibio.
UBICACION
1. Seleccione un lugar con un piso firme y nivelado.
2. Su refrigerador requiere ventilación. Deje un espacio mínimo de 5” hacia arriba y espacio
suficiente en el respaldo para permitir la circulación de aire.
3. Evite luz directa del sol o calor. La luz directa del sol puede afectar la capa de pintura. Las
fuentes de calor en su proximidad causarán un consumo mayor de electricida d.
4. Para un mejor desempeño, nivele el refrigerador utilizando las patas ajustables o tornillos
niveladores.
INSTRUCCIONES PARA LA CONECCION A TIERRA
Este aparato electrodoméstico debe estar conectado a t ierra. En caso de u n cort ocirc uit o eléct rico, la
conección a tierra reduce el riesgo de choque eléctr ico proporcionando un cable de escape para la
corriente eléctrica. Este aparato viene equipado con un cordón que posee un cable a tierra con un
enchufe de conección a tierra. Este enchufe debe estar c onectado en un tomacorriente instalado
correctamente y conectado a tierra.
ADVERTENCIA
El uso inadecuado del enchufe de conección a tierra puede resultar en un riesgo de choque eléctrico.
Consulte con un electricista si no comprende bien las instrucciones de conección a tierra o si existe
alguna duda sobre si el aparato está conectado a tierra correctamente.
NO USE UN CORDON DE EXTENSION ELECTRICA
Use un tomacorriente de pared exclus ivo. No conecte su refrigerador a cordones de prolongació n
eléctrica o junto a cualquier otro electrodoméstico en el mismo tomacorrient e de pared.
ADVERTENCIA IMPORTANTE:
Un refrigerador vacío es una atracción muy peligrosa para los niños. Quite los sellos magnéticos,
puertas o cerraduras de todo electrodo méstico que no esté en uso.
OPERACION
Para controlar la temperatura interna de la unidad ajuste el control a la temperatura ambie nte o para
el propósito que se use
La primera vez que encienda el refrigerador, ajuste el control de t emperat ura a la posición “6”
El alcance del control de temperatura oscila de la posición “OFF” (no enfriamiento) a la posición “6”
(máximo enfriamiento). Después de 24 horas, ajuste el control de temperatura a la posición que
mejor satisfaga sus necesidades.
La posición “4” es apropiada para el uso del refrigerador en el hogar u oficina.
Note:
Si la unidad ha sido desconectada, no tiene corriente, o fue apagada, deberá esperar de 3 a 5
minutos antes de volverla a encender. Si quisiera encenderla antes de tiempo la unidad no lo hará.
Si se ajusta el control de temperatura a la posición “OFF” la unidad dejará de enfriar pero no le
cortará la corriente al refrigerador
CERRADURA DE LA PUERTA
Su unidad viene equipada con una combinación de cerradura y llave.
Las llaves están dentro de la bolsa plástica junto al manual de instrucc iones.
Introduzca la llave en la cerradura y girela hacia la izquierda para abrir la puerta.
Para cerrarla, gira la llave hacia la derecha.
Quite la llave y colóquela en un lugar seguro para evitar que se pierda.
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CUIDADOS EN LOS PERIODOS DE AUSENCIA
• Para cort os períodos de ausencia (menos de 21 días) el congelador podrá quedar funcionando.
Coloque el botón de control de temperaturas en la posición mínima.
• En períodos de ausencia más largos, se aconseja dejar el refri gerador limpio y desconectado.
• Saque todo lo que tenga adentro del refrigerador y haga el deshielo y la limpieza general.
También retire las cubeteras, limpie bien y séquelas internamente.
• Deje la puerta entreabierta para que penetre el aire y as í evitar la formación de olores.
ECONOMIA DE ENERGIA
• Evite dejar por mucho tiempo la puerta abierta.
• Evite aperturas frecuentes de la puerta.
• Nunca coloque alimentos calientes dentro del refrigerador. Espere que estén a una temperatura
ambiental.
• Coloque el botón de control de temperaturas en la posición adecuada.
SI USTED SE VA DE VACACIONES
• Saque todos los artículos del refrigerador-congelador si Ud. se va de vacaciones por un mes o
más.
• Desconect e el refrigerador del tomacorriente y limpie el refrigerador bien, incluyendo la bandeja
del congelador.
• Deje la puerta abierta para evitar la formación de olores, condensación o moho.
SI USTED SE MUDA
• Desconect e el refrigerador del tomacorriente y limpie el refrigerador bien, incluyendo la bandeja
del congelador.
• Saque todas las partes movibles y empaquételas para que no se muevan durante la
transportación.
• Cierre la puerta del refrigerador y séllela con cinta adhesiva.
• Asegúrese que el refrigerador va parado durante el viaje y cúbralo con una frazada.
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REGISTRATION INFORMATION
Thank you for purchasing this fine Avanti products. Please fill out this card and return it within 100
days of purchase and receive these important benefits to the following address:
Avanti Products, A Division of The Mackle Co ., Inc.
P.O. Box 520604 - Miami, Florida 33152 USA
¾ Protect your product:
We will keep the model number and date of purchase of your new Avanti Products product on
file to help you refer to this information in the event of an insurance claim such as fire or theft.
¾ Promote better products:
We value your input. Your responses will help us develop products designed to best meet
your future needs.
----------------------------------------------------------(detach here)----------------------------------------------------------
Avanti Registration Card
__________________________________ _____________________________________
Name Model # Serial #
__________________________________ _____________________________________
Address Date Purchased Store/Dealer Name
__________________________________ ______________________________________
City State Zip Occupation
__________________________________ As Your Primary Residence, Do You:
Area Code Phone Number Own Rent
Did You Purchase An Additional Warranty:
Extended Food Loss None under 18 18-25 26-30
Reason For Choosing This Avanti Product: 31-35 36-50 over 50
Please indicate the most important factors Marital Status:
that influenced your decision to purchase Married Single
this product. Is This Product Used In The:
Price Home Business
Product Features How Did You Learn About This Product:
Avanti Products Reputation Advertising
Product Quality In Store Demo Personal Demo
Salesperson Recommendation Other_______________________________
Friend/Relative Recommendation Comme nts____________________________
Warranty _____________________________________
Other_______________________ _____________________________________
Your Age:
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