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Thanks for your recent purchase!
Please complete the following survey for your chance to win a $100 Gift Certificate.


Please rate the following items.
1 = very poor
2 = poor
3 = adequate
4 = very good
5 = excellent

STORE VISIT
Welcome Greeting 1    2    3    4    5    
Knowledge of Salesperson 1    2    3    4    5    
Friendliness of Staff 1    2    3    4    5    
Cleanliness of Store 1    2    3    4    5    
Overall Satisfaction 1    2    3    4    5    
Date of Visit
What store did you Visit? Fond du Lac    Beaver Dam    Warehouse Sale (city of the Warehouse)
We'd Like to ask you a few questions regarding the Delivery of Your Products (if applicable):
Timeliness of Delivery: 1    2    3    4    5    
Professionalism and Courteousness of Delivery Personel: 1    2    3    4    5    
Explanation of Product Usage from Delivery Personel: 1    2    3    4    5    
Overall Satisfaction of Delivery and Installation: 1    2    3    4    5    

Comments:


Which radio stations do you listen to?
KFIZ AM K107 (107.1) WMDC (The Great 98)  WTCX (96.1) 
WFDL (97.7) WXRO (95.3) WBEV AM The Fox (96.9)
WPKR (99.5) iPod XM SIRIUS
Other

Which newspapers do you read?
Action Advertiser Action Shopper Tri-County Other
FDL Reporter  (Subscriber   Non-subscriber)
Dodge County Pioneer  (Subscriber   Non-subscriber)

Which television stations do you watch?
ABC CBS NBC FOX
HGTV TLC Lifetime Weather Channel
History Travel Food Network ESPN
CNBC Fox News

How do you prefer to learn of upcoming sales?
Radio Newspaper Shopper
TV U.S. Postal Mail Internet (Website or Email)

May we use your comments as a testimonial in our marketing?
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