1.

* 1. Store Visited.

* 2. Date and time of visit.

Date/Time
/
/
:

* 3. Were you properly greeted when you entered the store?

* 4. Were you assisted in the aisle while shopping?

* 5. How would you rate the appearance of our store?

* 6. Please rate each department based on the quality of items and the variety of selections.

  Very Good Good Fair Poor Very Poor
Meat
Produce
Grocery
Freeze & Chill

* 7. Do you feel your importance as a customer was truly appreciated?

* 8. How would you rate our cashier's customer service?

* 9. Was the Store Manager or Assistant Store Manager present in the front during your checkout?

* 10. Please rate your shopping experience.

* 11. How would you rate Pay-Less customer service compare to other grocery stores on island?

* 12. What would you like to see improved in our stores to better serve you?

* 13. Contact information (Optional)

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