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Nature's Emporium Customer Survey
1. Default Section
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1
. How likely are you to recommend Nature's Emporium to a friend or relative? Would you say the chances are…
How likely are you to recommend Nature's Emporium to a friend or relative? Would you say the chances are…
Excellent
Very Good
Good
Fair
Poor
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2
. How likely are you to repurchase products from Nature's Emporium? Would you say the chances are …
How likely are you to repurchase products from Nature's Emporium? Would you say the chances are …
Excellent
Very Good
Good
Fair
Poor
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3
. Nature's Emporium is a locally owned business for 40 years. How long have you been a customer of ours?
Nature's Emporium is a locally owned business for 40 years. How long have you been a customer of ours?
First Visit
1-5 Years
5-10 Years
10 Years or Longer
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4
. What brings you into our store today? (You may select more than one answer)
What brings you into our store today? (You may select more than one answer)
Pet Food
Pet Supplies
Live Animals
Gift Department
Pond Equipment
Just Looking Around
5
. We are interested in any feedback you may have on our store.
We are interested in any feedback you may have on our store.
6
. Please provide us your contact information.
Please provide us your contact information.
Name:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code:
Country:
Email Address:
Phone Number:
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