Hoosier Pete

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We Listen To You!






We Listen To You!

Please tell us how you feel about our Hoosier Pete Convenience Stores. Simply complete the information below, fill in the appropriate boxes and buttons on this form and click on the SUBMIT button.

Your patronage is appreciated.



  Your Name:    

  Your Address:

                City:   

              State:      Zip:


Location Visited:

HOW OFTEN

1st Visit
Sometimes
Frequently
Regularly


JAN
FEB
MAR
APR
MONTH

MAY 
JUN 
JUL
AUG 


SEPT
OCT

NOV
DEC
DAY

MON
TUE
WED
THU
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SUN


TIME OF DAY OF STORE VISIT

(7 am - 3 pm)           (3 pm - 11 pm)           (11 pm - 7 am)

Gender:           I am:


To serve you better, please mark only those items you experienced this visit and feel strongly about.
Grading System: Poor, Fair, Good, Excellent

 FUEL GRADE
 Poor    Fair     Good   Excellent
Clean fuel islands

                                    

Competitive prices

                                    

Adequate supplies

                                    

Courteous counter people

                                    

Efficient cashier

                                    

   
  OUTSIDE GRADE
 Poor    Fair     Good   Excellent
Overall Cleanliness

                                    

Appearance of grounds

                                    

Adequate lighting

                                    

Parking conditions

                                    

   
  STORE GRADE
 Poor    Fair     Good   Excellent
Cleanliness/appearance

                                    

Cleanliness of restrooms

                                    

Courteous/professional cashiers

                                    

  Variety of merchandise

                                    

Price of items/value

                                    

Prompt/efficient service

                                    

Access to management

                                    

   
  DELI/FAST FOOD GRADE
 Poor    Fair     Good   Excellent
Friendly/professional staff

                                    

Variety of food offerings

                                    

Appearance/taste of food

                                    

Portion size/value

                                    

Cleanliness/housekeeping

                                    

Prompt/efficient service

                                    

Additional Comments:

Thank you for visiting our location and taking the time to complete this comment form.