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  Customer Survey/Giveaway

By completing the following survey you will be entered into a monthly drawing for a gift certificate to local restaurants and businesses. We appreciate you taking the time to help us better serve you!

About You
First Name:*
Last Name:*
Address:
City:*
State: Zip:
E-mail:*  
Phone:*
   
About Our Service

 

1) How did you hear of Harrs Auto Glass?
Yellow Pages Word of mouth Internet Other
If other how?
2) Have you ever had your auto glass replaced at Harrs?
Yes No
3) How many times in the past 5 years have you had your auto glass replaced?
None 1 2 3 or more times
4) If your auto glass needs replaced who is the first person you would call?
Your insurance agent Local Glass shops Someone for advice Other, If other how?
5) Are you aware that by law it is your choice to take your car where you want for an auto glass replacement regardless of where your insurance agent recommends you to go?
Yes No


*
Indicates required information.

By completing this form you will be entered into a monthly drawing for gift certificates and prizes. The winner will be posted on the home page each month. We appreciate the opportunity to serve you!



 
   
 
 
   
 

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