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* 1. Store Visited.

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* 2. Date and time of visit.

Date/Time

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

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

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

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* 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

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

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

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

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* 10. Please rate your shopping experience.

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

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

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* 13. Contact information (Optional)

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