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* 1. Please enter your name and phone number.

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* 2. How did you hear about us?

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* 3. How likely is it that you would recommend Kim's to a friend or colleague?

NOT AT ALL LIKELY
EXTREMELY LIKELY

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* 4. Are you satisfied with our store hours?

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* 5. Which of the following words would you use to describe our products? Select all that apply.

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* 6. What would you like to see more of?

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* 7. How long have you been a customer of our company?

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* 8. How likely are you to purchase any of our products again?

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* 9. What brings you back to us?

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* 10. What, if anything, can we do to improve your shopping experience at Kim's?

T