Name:
   
Email Address:
   
Date of Car Wash:
   
Car Wash Package Purchased:
   
Prior to today, when was the last time you had your car washed?
Last Week One Month
Last fall One Year
   
Where was your car washed last time?
Tops Another conveyor (like Tops)
Gas Station Touchless Other
   
How did you hear about us?
Coupon Internet
Newspaper Word of Mouth
Radio Signs
What is your primary reason for choosing Tops Car Wash?
Quality Wash/Detail Good Value
Close to work/home Coupon
Quick Service Friendliness of employees
Rate Our Performance
1. Exterior Cleanliness     
2. Interior Cleanliness     
3. Level of respect shown for your vehicle     
4. Friendliness and helpfulness of staff     
5. Speed of service     
6. Value for price charged     
7. Cleanliness of facility     
8. Overall Satisfaction with your experience     
How likely are you to recommend Tops Car Wash to others?
Very Likely   Somewhat Likely   Not Likely
Please leave any additional comments in the box below:

Thank you for your time. We value your feedback.