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Survey
General Contact Information
First Name
Last Name
Email
Phone
Age
< 25
26-33
34-40
41-47
48-55
56-65
66+
Marital Status
Single
Married
Divorced
Children
Birthdays
Mom
Jan
/
/
Dad
Jan
/
/
Child #1
Jan
/
/
Child #1
Jan
/
/
(If they chose 3 children, give them three children birthday options, four - four, etc...)
I would like to be signed up for your birthday email club where I can receive coupons, freebies and birthday wishes!
Questionnaire
How often do you visit Servatii's
Never
1x Year
2-5x Year
1x Month
2x Month
Weekly
Other
Why do you come this many times?
Where would you like us to open a new store?
Stores
What Store(s) do you visit?
(Please Rate Your Last Visit)
Over Store Cleanliness
1
2
3
4
5
Employee Appearance
1
2
3
4
5
Employee Knowledge
1
2
3
4
5
Other Feedback
Website
Rate our website
1
2
3
4
5
What feature(s) can we add or remove?
What other bakeries do you visit and what do you like about them?
What product/services or features could we add to help us better serve you?
Regarding our current products/services or features what would you change?
What is your favorite product(s)?