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Date of interview
MonthDayYear
  
 
 
 
Start of Interview
   
 
 
 
What was your purpose in coming to this dtore today?
 
Purchase a particular item
 
See what was available in stock
 
Look around store
 
Meet my mother
 
Meet other mothers
 
Get out of the rain
 
Buy a present for someone
 
Other
 

 
 
 
What did you come to this store to buy today?
 
Nursery furniture
 
Nursery bedding
 
Children's bedroom furmiture
 
Children's bedding
 
Large toys
 
Small toys
 
Outside play equipment
 
Games
 
Musical toys
 
Other
 

 
 
 
Email Address
   
 
 
Contact Information
First Name : 
Last Name : 
Phone : 
Email Address :