Treat yourself to the world's Elite Coffee. Please complete our official "Coffee Connoisseur Registry" form to become an honorary member of our distinctive registry which entitles you to receive a FREE 2 ounce sample of the unique Ospina Estate Coffee. To receive your complementary gift of the world's most extraordinary coffee please send a S&H fee as indicated below. Thank you.

Please note. All fields marked with an asterisks (*) are required.
I. Contact Information
First Name *
Last Name *
Email *
Phone Number *
 -   - 
United States Addresses Only
Address *
Address
City *                 State *        Zip *
     
International Addresses Only
International Address *
International Address
County/Province/State *
Town/City *
Postal Code *
Country *
II. Personal Information
1. Gender *
Female
Male
3. Age Group *
Under 25
25-34
35-44
45-54
55-64
Over 65
5. Occupation *
2. Level of Education *
High School
College
Graduate
Post Graduate
4. Annual Income *
Below $25000
$25000-$50000
$50000-$75000
Above $100000
III. Interests
6. What is your favorite hobby? *
7. What is your favorite sport? *
8. What is your favorite magazine? *
9. How did you hear about Ospina Coffee? *
At a Store
News Article
Magazine Ad
Internet Search
Internet Ad
Coffee Website
From a Friend
Other
IV. Coffee Preferences
10. How do you prefer your Coffee? *
Regular
Decaf
Flavored
12. How do you prefer the roast? *
Light
Medium
Dark
Espresso
14. Where do you prefer to buy your fresh coffee? *
Department Store
Grocery Store
Delicatessen
Specialty Shop
Direct from Roaster
Internet/Online
16. What is your favorite brand of coffee? *
11. How do you buy your coffee? *
Whole Beans
Ground
Instant
13. How do you brew your coffee? *
Auto Drip
French Press
Espresso
Vacuum Method
15. Which is your favorite coffee origin? *
Colombia
Hawaii
Costa Rica
Ethiopia
Indonesia
Jamaica
Guatemala
Kenya
Other
V. A Few Questions
17. Have you ever ordered fresh coffee through the Internet (Online)? *
Yes
No
18. Have you tasted OSPINA ESTATE COFFEE, the World's Elite Coffee? *
Yes
No
19. Would you like to receive more information, news, promotions and special offers from Ospina Coffee Company? *
Yes
No
VI. Thank You
Upon completion of this form, you have entered our "Coffee Connoisseur Registry". As a distinguished member you are entitled to receive a free 2 oz sample of Ospina Estate Coffee. Please mail a check or money order (made out to Ospina Coffee Intl.) to cover the packaging, shipping and handling expenses of your gift. If your address is in Canada or the USA, please mail $4.95. If it is in any other country, mail $6.95. We will immediately send your FREE Ospina Estate Coffee sample. Please limit one entry per customer. Thank you.

Ospina Coffee Company, Inc.
3116 Weddington Road
Suite 900, Box 150
Matthews, NC 28105
U. S. A.
Privacy Policy