Survey

BIG MAC'S DISCOUNT SALES wants to know about our customers.Please complete this questionnaire and click the button to send us your comments.

1. First Name *

2. Last Name *

3. Email Address *

4. Website Address (URL)

5. Home Phone

6. Age ?  17 or under 18-22 23-29 30-39 40-49 50-59 60 or above

7. Street

8. City

9. Gender ?   Female   Male

10. Zip *

11. How many people in your household ?  1 2 3 4 5 6 7 or more

12. Comments

13. Country

14. How did you hear about us ?  Friend or Associate Yellow Pages Magazine/Newspaper Article Print Ad Radio Ad TV Ad Business Card Flyer Newsletter Email Banner Ad Other Website Tradeshow Web Ring Word of Mouth

15. What would you like Big Mac to offer you at BIG MONEY SAVINGS on this web site?

16. Have you ever purchased anything online before?   Yes     No

17. What would motivate you to purchase items online?