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Surveys
2014
December
B
BELLE FORME Customer Personalization Chart
BELLE FORME Customer Personalization Chart
BELLE FORME
0%
Exit Survey
Name: First Last
Birthday:
Month
Day
Year
--
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
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01
02
03
04
05
06
07
08
09
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12
13
14
15
16
17
18
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20
21
22
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30
31
--
1900
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1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
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1920
1921
1922
1923
1924
1925
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1927
1928
1929
1930
1931
1932
1933
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1935
1936
1937
1938
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1994
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2000
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2003
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2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
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2034
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2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
2049
Address:
Email:
Phone:
What is the
Most Important
feature you look for in a bra (Rank 1-5):
Comfort
Fit
Support
Look
List your
Primary Concerns
with your
current
bras (Rank 1-5)
Quality
Fit
Support
Comfort
What is your current bra size? Panty Size?
How did you hear us?
Notes:
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