| First Name: * |
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| Last Name: * |
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| Street Address: * |
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| City, State, Zip: * |
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| Telephone: * |
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| Email Address: * |
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Optional Information:
If you'd like to receive periodic, personalized offers, coupons, rebates, seasonal promotions, contest information and more,
simply complete the rest of this questionnaire. The Fussy Cleaners will send you the information that fits your dry cleaning needs and preferences.
Your information will be kept private. For more information, pleae read our
Privacy Policy. |
| Gender |
Male
Female |
| Birth date (Month & Day Only) |
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| Age Group |
18-24
25-40
41-54
55+ |
| Household income. |
Up to $45K
$45K to $75K
Over $75K |
| How often do you use dry cleaning services? |
Weekly
Every other week
Monthly |
| Check the three types of articles that you have dry cleaned most often? |
shirts
pants
suits
skirts
dresses
blouses
gowns
sweaters
coats/jackets
leathers/suedes
blankets/bedspreads
comforters
tableclothes
drapes |
| Are you a current Fussy Cleaners user? |
Yes
No |
| If yes, how do you use our services? |
walk-in
drive-thru
pickup/delivery
online |
| How did you first hear about Fussy Cleaners? |
Newspaper
Radio
TV
Friend
Internet
Saw Your Van |
| Favorite radio station? (fill in) |
|
| Favorite TV program? (fill in) |
|
| Rank the following as they apply to your choice of a dry cleaner. |
| Money Saving Coupons |
very important
important
not important |
| Location |
very important
important
not important |
| Price |
very important
important
not important |
| Customer Service |
very important
important
not important |
| Pickup and Delivery Service |
very important
important
not important |
| Local Ownership |
very important
important
not important |
| Environmentally Friendly Processes |
very important
important
not important |
| Full Range of Additional Services |
very important
important
not important |
Winners will be notified via email and names will be posted on this site. Click here for complete contest rules. |
© 2008 The Fussy Cleaners
