* 1. Please enter the date of your last order, and the "A" order number:

* 2. What do you think of the products you bought?

* 3. What did you think of our service levels?

* 4. Would you buy from ADAPT again?

* 5. How could we improve our service?

* 6. If convenient, please may you give us a short testimonial about our products and/or service:

* 7. May we please use your name and/or testimonial in our marketing materials?

* 8. Would you recommend ADAPT to someone else?

* 9. Please may you refer us to someone who may like our products:

* 10. Please enter your contact details to enter our monthly lucky draw to win an ADAPT Cooler, valued at R1500 - R2500:

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