Questionnaire

Thanks for using our discounts page. By completing this page and bringing a copy of it with you when you bring your car in for service (at initial visit only please), you will realize the following discounts on our repairs or installations. Repairs or installations from:

 
$0-$300 = $5   off
$301-$1000 = $10 off
$1001-$2000 = $20 off

Please Note: Wholesale customers can not receive these discounts. Discounts are based on one per customer, vehicle and / or repair or installation. These discounts may not be applicable with other discounts that may have already been given.

The information you are providing us is simply being used to better understand and serve you our customers. The information you provide will in no way be distributed to anyone else, it is for our internal use only ! Thanks for taking the time to fill this out and we hope to see you soon.

Note: There is a map at the end of this page you can print out to find us as well as extra discounts !

Name
Title
Company
Address
City
State
Zip
Phone
Email
Year
Make
Model

Questions ?

1) How did you hear about Polar Bear? Please check all that apply.
Radio
TV
Cable
Referral
Newspaper
2) Yellow Pages: Please check all that apply.
Pacific Bell
Local Touch
Roseville
Pacific West
Valley
Transwestern
License Plate
3) What type of service are you having performed? Please check all that apply.
A/C service or repair
New A/C system installation
Cooling System Service
Heater repair
Electrical repair
A/C Hose or tube repair
Tune-up
Brakes
Transmission Service
"K" Services
4) How important are these things to you?

Nice waiting room
Important
Not Important

Shuttle service
Important
Not Important

Repair performed on time
Important
Not Important

Reputation of repair shop
Important
Not Important

ASE Certification
Important
Not Important

MECP Certification
Important
Not Important
5) How old are you?
Under 18
18-24
25-34
35-44
45-54
55 +
6) Gender?
Male
Female
7) Occupation?
Professional
Executive/Manager/Administrative
Clerical/Sales/Technical
Precision/Craftsman/Repairman
Student
Retired
Not Employed
Other
8) Education?
Some High School
High School
Some College
College Degree
Some Post Graduate
Post Graduate Degree
Question...
If you have been quoted prices around town would you please give us some feedback on what you found. This information is worth an extra $5.00 off any repair or installation with us.
Company
Quote
Company
Quote
Company
Quote
Company
Quote

Please click here to view a map to our location or get driving directions.


Email:kevin@polarbear-air.com
This site has been optimized for viewing with IE 6.0 and a screen size of 800 x 600

Copyright 1999-2007 Jesmon Enterprises Inc. DBA Polar Bear Auto Air- All rights reserved