• Product Purchase Survey Form

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• Customer Name*
• Email*
• Phone

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• Address

  Street Address 1

  Street Address 2

  City

  State/Province/Region

  Postal/Zip Code

  Country

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• How did you make your purchase?* Select In Store Website
• How did you shop?* Select Researched website, then purchased in store Found in store then purchased on website Went directly to store and purchased Went directly website and purchased
• Were you able to find your product, in-store or on our website, on your first visit?*

  Yes No
• Did you compare pricing with other retailers?*

  Yes No
• Why did you decide to purchase your product from us?* Select Price Quantity available Speed of delivery Store was nearby Able to purchase on website, then pick up in store Ease of returns
• Is this product consistantly in stock in our store and on our website?*

  Yes No This is my first time purchasing it here
• Based on your shopping experience, will you purchase this product from us in the future?*

  Yes No Unsure
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• Product Information

  Product Name	Size	SKU or Model #	Price

• Feedback