Customer Survey Form

First Name
Last Name
Age
Sex	Male Female

Where did you see our advertisement?

No where
television / Weather channel
internet
radio
location
referral ( word of mouth )
yellow pages
Daily News
Thrifty Nickel / American Classified Ads
Eglin Eagle
Hurlburt Commando

How many vehicles in your household?

  None
One
Two
Three
Four or more.

How many accessories and/or services have you purchased from Accent Tops & Trailers (if any)?

  None
One - Two
Three - Five
Six - Eight
More than Eight

Did you know that Accent carries accessories for all types of vehicles?

  Yes No

Have you been to our Ft Walton Beach location on Beal Parkway?

  Yes No

How would you rate us against our competition?

  Not good
Ok
Average
Great
Outstanding

Have you ever had a product installed at Accent Tops?

  Yes No

If yes, was the installation done in a timely manner?

Yes No

Would you recommend us to a friend or family member?

  Yes No