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	Name
	Order number*
	Your email *
	Testimonial Message
	Suggestion(s)
	Ratings: 5 = Excellent; 4  = Good; 3 = Average; 2  = Bad; 1  = Terrible; No comment
	Customer Care Friendliness	5  4  3  2  1  No comment
	Customer Care Efficiency	5  4  3  2  1  No comment
	Website Design	5  4  3  2  1  No comment
	Website Functions	5  4  3  2  1  No comment
	Website User Friendliness	5  4  3  2  1  No comment
	Product Quality	5  4  3  2  1  No comment
	Shopping Experience	5  4  3  2  1  No comment
	Your Overall Experience	5  4  3  2  1  No comment
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	Note: You have one last step to activate the posting which can be done on the next page or through your email. We appreciate you taking the time to fill out our questionaire. Please go to your email to activate the posting. We hope to use your feedback to improve our services. We reserve the right to make the decision to post or remove your comments when you agree to post publically.
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Ratings: 5 Excellent 4 Good 3 Average 2 Bad 1 Terrible

	John Taylor Ratings: Website Design ; Website Functions ; Shopping Experience ;

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