Name: |
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Email Address: |
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Phone #: |
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Address: |
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Where did you hear about us? |
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To enter the drawing, please describe here the things you DON'T like about your current bed. |
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How soon would you like a new bed? |
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Would you be interested in a demo, scratch and dent, or seconds bed? |
Yes
No
Maybe
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Would you be interested in attending a Sleep Seminar (about 1 hour) for extra discounts and freebies? |
Yes
No
Maybe
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Have you been into any MyComfort Store before, or any other store that sells gel beds? |
Yes
No
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If yes on the previous question, which location? |
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To help us better understand our customers, what age are you? (optional) |
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To help us better understand our customers, how much do you make annually? (optional) |
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Finally, has a doctor, therapist, or Chiropractor ever told you that a new bed could help you? |
Yes
No
Not sure
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