Survey Form

Name:
Email Address:
Where do you normally go for shopping? Giant
Aeon Big
Jusco
Mydin
Others
What are the usual things that you buy in a month? Personal care
Household care
Food & Beverage
Health supplements/ vitamins
Beauty Products
Others
How much do you spend average per month?
Do you have an internet access at home / office?
Are you comfortable making purchase through internet
Please tick your interest: Facial session
Product Knowledge
Earn Side Income by learning to change your buying habits
Earn RM5k or more/month in 2~5 years

Put a website form like this on your site.

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