Southern States Customer Feedback

At Southern States, our customers feedback is important to us. We want to hear from you regarding your experiences with our stores, our web sites and the services we offer. What type experiences have you had, how can we improve, and what would you like to see from us in the future?

This survey comprises several quick questions. Please take a few minutes and provide us with your input. We thank you for your feedback.

Southern States Management Team

1. How would you rate your most recent experience with Southern States? *This question is required.

Space Cell	Excellent	Good	Average	Poor	Terrible
Rating

2. How likely are you to recommend Southern States to a friend or colleague? *This question is required.

Space Cell	Definitely	Very Likely	Possibly	Not Likely	Never
Recommendation

3. What city is this Southern States located in (or are you a web site user)? *This question is required.

Please enter an 'other' value for this selection.

How would you rate your SouthernStates.com web site experience?

Space Cell	Very Satisfied	Satisfied	Neutral	Dissatisfied	Very Dissatisfied	Not Applicable
Overall * *This question is required
Articles & Information
Site Navigation
Site Search
Product Information & Prices
Customer Service

4. Customer Type: We are interested to know how you identify your relationship with Southern States as a customer. If none of the catagories listed seem to match, feel free to fill in your own below. Check all that apply. *This question is required.

Large Farmer
Small / Medium Farmer
Lawn & Garden
Country Living / Rural Lifestyle
Pet Owner
Petroleum
Other Please enter an 'other' value for this selection.

5. What improvements would you like to see at Southern States and its websites?

6. What do you like best about Southern States?

7. What do you like least about Southern States?

8. What products / items would you like to see at Southern States that you have not found in your store?

9. Please fill out the following customer information (only City, State & Zip are required fields). We strive to follow up on actionable feedback, so feel free to provide a contact point below. *This question is required.

First Name

Last Name

City *This question is required.

State *This question is required.

Zip *This question is required.

E-Mail Address *This question is required. This question requires a valid email address.

Phone Number

From time to time Southern States would like to e-mail information about upcoming events and special offers to registered Southern States web site members.

Would you like to receive future feedback and offers from Southern States at the e-mail address provided above? *This question is required.