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How was your shopping experience at the store you visited?

NAME *:

STORE VISITED *:

EMAIL ADDRESS *:

DATE OF VISIT *:

TEL NO. *:

TIME VISIT *:

Staff was courteous and smiley
Very SatisfiedSatisfiedSomewhat SatisfiedVery Dissatisfied

Staff was knowledgeable about the products
Very SatisfiedSatisfiedSomewhat SatisfiedVery Dissatisfied

Staff was informative during the selling process
Very SatisfiedSatisfiedSomewhat SatisfiedVery Dissatisfied

Shopping experience was relaxed & comfortable
Very SatisfiedSatisfiedSomewhat SatisfiedVery Dissatisfied

Overall store cleanliness/tidiness
Very SatisfiedSatisfiedSomewhat SatisfiedVery Dissatisfied

Name of outstanding service staff (if any):

His/her service that delights me:

Other suggestions / comments:

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