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Customer Feedback . . .
Please take a few moments to tell us about your visit to a Color Me Mine studio. The information you provide will remain confidential.

Customer Feedback Form


Name
Email Address
This form cannot be processed without a valid email address.
Phone
Date & Time visited
Receipt number
Your gender?
Female Male
Marital status?
Single Single parent Married No answer
Your Age Group?

Under 12
13-17
18-24
25-34
35-44
45-54
55-65
65+
No answer
I usually visit Color Me Mine:
During the Day Evenings No answer
Weekday Weekend No Answer
How often do you visit Color Me Mine?
One or more monthly Several per year Holidays only First time visit No answer
My last visit was:
Planned in advance Spur of the moment No answer
I visit Color Me Mine for:
Creating personal gifts Make something for myself No answer
Distance you live from the studio:
Under 1 mile 1-3 miles 3-5 miles 5 miles plus No answer
Cable TV shows I watch:
Food Cartoon Exercise Home/Garden None 0f the options
Amount spent?
$25 or Less $26 to $50 $50 or More No answer
Friendliness Of Staff?
Excellent Good Fair Needs improvement No answer
Staff member(s) knowledgeable?
Excellent Good Fair Needs improvement No answer
Staff attentive to my needs?
Excellent Good Fair Needs improvement No answer
Cleanliness?
Excellent Good Fair Needs improvement No answer
Atmosphere?
Excellent Good Fair Needs improvement No answer
Overall Value?
Excellent Good Fair Needs improvement No answer
Variety?
Excellent Good Fair Needs improvement No answer
Overall Experience?
Excellent Good Fair Needs improvement No answer
I want to learn more about:
(Check All That Apply)
Children's classes
Adult classes
Birthday parties
Showers
Scout programs
After school programs
Will you visit again?
Yes No
Please give us one suggestion as to how we can improve your experience.
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