Personal Info (optional)


(Example: 222-333-4444)
Would you like us to contact you?
Please fill in the required info located from your receipt.

Store # Trn # Reg #
Sales Associate # Date  

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1. Did you leave our store happier than when you arrived?     
    Please explain.

2. Would you recommend our store/boutique to a friend?     
    Please explain.

3. How would you rate your  experience, 10 being the best and 1 being the worst?    
    Please explain.

4. Any other comments?