E-Mail address

First Name

Last Name

Mailing address

City, State Zip

1. What is your Gender?
Male
Female

2. What is your age group?
18-24
25-31
32-40
41or Older

3. Which apparels store do you most frequently shop at?
Store 1
Store 2
Store 3
Store 4
Store 5
Store 6
Store 7
Other (please specify)

4. Which apparels store did you shop last time for yourself or your family members?
Store 1
Store 2
Store 3
Store 4
Store 5
Store 6
Store 7
Other (please specify)

5. Was store clean and neat?
Yes
No

6. Was your presence acknowledged within a short time of arrival?
Yes
No

7. Was lobby/waiting area clean?
Yes
No

8. Were you greeted in a friendly manner?
Yes
No

9. Were employees dressed professional?
Yes
No

10. Did they offer to assist you with problems?
Yes
No

11. Were they courteous?
Yes
No

12. Were the dressing rooms clean?
Yes
No

13. Did they know their products well?
Yes
No

14. Did they thank you for shopping?
Yes
No

15. How do you rate this establishment?
Excellent
Good
Fair
Poor

16. Based on your experience, would you shop at this location again in the future?
Yes
No
Can't Say

17. How often do you shop for apparels per year?
2-3 times a month
Every month
once every 2 -3  month
once every 4 - 6 month
few times a year
once or less then once per year

18. On average, how much money do you spend on clothing in
total per month?
under $50
$50 to $100
$101 to $200
$201 to $300
$301 to $400
$401 to $500
$501 or more

19. Have you ever shopped online?
Yes
No

20. Have you ever pulled coupons or special offers from newspapers to use when shopping for clothing?
Yes
No

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Note: This is a sample survey of what you will be paid to participate in. You will not be paid for this survey. Actual paid surveys may be longer.