| Invoice TX #? * |
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| What is your name? |
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| What is your zip code? * |
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| Phone Number * |
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| How did you hear about our store? |
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| What attracted you to our store? |
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| Who assisted you with your purchase? * |
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| How would you rate the in store service you received? * |
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| Did a warehouse staff member assist you * |
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| If yes, who assisted you? * |
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If yes, how did they assist you?
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| How would you rate the service you received? * |
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| Any additional comments? i.e. improved customer service?, different or other product selection?, etc: |
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