Arizona Fireplaces

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CUSTOMER FEEDBACK FORM

First Name:
Last Name:
Company Name:
Email Address:
Phone Number:
City:
State:
Zip/Postal Code:
Current Customer?	Yes No
How Did You Hear About Us?	Retailer Friend/Relative Google Yahoo! MSN Print Ad Email Campaign
If you chose Google, Yahoo! or MSN, what keywords did you use when searching?
Preferred method of communication (select all that apply):	Email Phone Postal Mail
Comments:

Thank you for taking the time to provide us with this information. We appreciate your comments and suggestions. Your valuable input helps us as a company to continually improve and assists us in meeting our goals of complete customer satisfaction.

Best Regards,

Don Richardson
President & Founder
Arizona Fireplaces