Free Marketing Re-engagement Questionnaire

Name

Please enter your full name as we'd like to know who you are.

Date of Birth

Your date of birth helps us tailor our communications to you.

Email

Please provide your email address so that we can stay in touch.

Phone Number

We may reach out to you via your phone number if preferred.

Address

Knowing your location helps us provide better services.

Preferred Contact Method

Choose your preferred method of contact.

• Phone

• Email

• Mail

Additional Information

Provide any additional comments or feedback you may have.

Please check the box below to proceed

Confirm that you are not a robot by checking the box.

Are you interested in our loyalty program?

Let us know if you'd like to benefit from our exclusive loyalty program.

• Yes

• No

What was your last experience with us like?

Share your most recent experience, whether positive or negative.

Which products are you most interested in?

Select all products you find interesting or wish to learn more about.

• Product A

• Product B

• Product C

How satisfied are you with our services?

Rate your overall satisfaction with our services.

Do you prefer shopping online or in-store?

Select your preferred shopping method.

• Online

• In-Store

Are you interested in attending our events?

Let us know if you would like to be informed about upcoming events.

• Yes

• No

Would you like to receive our newsletter?

Subscribe to our newsletter for the latest updates and offers.

• Yes

• No