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Dear Respondent,
I Ankit Agarwal is a student of C.R.I.M College, Bhopal and doing a research for a study for
which I intend to pose a questionnaire aimed at analyzing the Impact of shopper, store &
situational factors on store image, satisfaction and loyalty of customers .
Your cooperation is deeply solicited to provide the relevant information. I assure that
information will be kept confidential.

Name of Customer _______________ Mobile No.______________

Please tick at the place that matches your opinion.

A. Details

1. Through which source did you come to know about this retail outlet?

Company Outlet
Internet 2.

2. How strongly would you consider the factors while opting for a particular retail

1- Very Strongly 2- Strongly 3- Agree 4- Not at all

Statement 1 2 3 4
A Availability of Literatures/Brochures
b. Ambience would be an important factor
c. I would give special attention to convenience and location
d. I would give special consideration to the product range
e Degree of differentiation in type and quality of products is important
f. I would give special consideration to uniqueness of assortments
available in a store
g I would give special consideration to rebate and discounts on purchase
h. For me salesperson services would be an important consideration
i For me Word of Mouth is important
J Advice of friends and relatives influence my Visit Decision
k. Handling Product related Queries
l Customer Grievance cell

B. Salesperson Services

3. Are the salesperson (Rate the salesperson services according to you from 1 to 5, where
5 is extremely good and 1 is extremely bad)|

Statement 1 2 3 4 5
a. Easily approachable
b. Humble and Soft Spoken 1 2 3 4 5
c. Able to provide Complete solution
to your problems Rate
d. Initiative of salesman to solve the Overall
problem salesperson

4. How do you perceive quality of service provided by your retail outlet (Using Semantic
Scale 1-7, 1 being the lowest, 7 being the highest)

7 1


C. Retail outlet factors

5. How far are you satisfied with the following factors for your retail outlet?

1- Very Dissatisfied 2- Dissatisfied 3- Satisfied 4- Very Satisfied

Statement 1 2 3 4
a. Price of the items
b. Convenience in approach
c. Assortment
d. Extra services provided
e. Home delivery service
f. Transparency In Billing
g. Ease of availability
h. Sales person Services
i. Sales Promotion Offers
j. Advertisement
k. Store Ambience
l. Overall Satisfaction Level

6.Overall – how much are you satisfied with the service of your retail outlet?

Extremely Satisfied Moderately Moderately Dissatisfied Extremely

Satisfied Satisfied Dissatisfied Dissatisfied

If Not Satisfied, Specify Reason(s)?

7. Have you faced any problem with your store? ___________

If yes, what type of problem you faced?
Quality of products
After sales service
Assortment size
Employee behavior
Any Other (Specify) __________________________

D. Future relationship

8. Rank the following from 1 to 4 where

1- Strongly Disagree 2- Disagree 3- Agree 4- Strongly Agree

Statement 1 2 3 4
A Consider buying from this store
B Increase the purchase from this sectors

E. Trust

9. Rank the following from 1 to 4 where

1- Strongly Disagree 2- Disagree 3- Agree 4- Strongly Agree

Statement 1 2 3 4
A Find products reliability
B I trust the services by the store

F. Commitment level

10. Rank the following from 1 to 4 where

1- Strongly Disagree 2- Disagree 3- Agree 4- Strongly Agree
Statement 1 2 3 4
A I am proud to be a customer of this retail outlet.
B Company gets feedback from me from time to time.
C I am a loyal patron of this company.

G. Customer’s profile (kindly tick the suitable box)

11. Age 12. Occupation:

< 18 years Student Professional
18 –25 years Private Employee Self Employed
25 – 40 years Government Employee
40 above Other (Please

13. Gender 14. Education 15. Disposable Income (p.m.)

Male Matriculation < Rs. 5,000

female Senior Rs. 5,001- Rs. 10,000

Secondary Rs. 10,001- Rs. 20,000
Bachelor Degree Rs. 20,000 plus
PG Degree

16. No. of times visiting the retail outlet per week

Less than once

1-2 times

5 times
More than 4 times
(Thanks for Co-operation)