Rate your experience with ADAPT and be eligible to win an ADAPT Cooler, valued at R1500 - R2500.

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

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

Date of Last Order

"A" Order Number

What do you think of the products you bought?

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

Excellent

Good

Average

Bad

Terrible

Excellent

Good

Average

Bad

Terrible

What did you think of our service levels?

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

Excellent

Good

Average

Bad

Terrible

Excellent

Good

Average

Bad

Terrible

Would you buy from ADAPT again?

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* 4. Would you buy from ADAPT again?

Yes

How could we improve our service?

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* 5. How could we improve our service?

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

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

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

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

You may use my name and/or company name.

You may use my testimonial.

Would you recommend ADAPT to someone else?

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* 8. Would you recommend ADAPT to someone else?

Yes

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

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

Name

Company

Email Address

Phone Number

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

Question Title

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

Name

Company

Email Address

Phone Number