Customer Survey / Record Update Form

*Name:

Account #:

*Mailing Address:

*City:

*State IA NE  Zip

Home Phone: Work Phone: Cell Phone:

Email Address:

Do you have any comments, suggestions or questions about the service we have provided for you this year?

Would you still like to receive a call ahead before each service?     Yes No

If a call ahead is needed, is it ok to leave a message? Yes No

When calling ahead do we need to speak with someone specifically? Yes No
If so, person to speak with:

Are there any special instructions that we should notate on your account?
For example: have gates, gate locked, has dog

Do you have an irrigation system: Yes No
If yes, how many zones: 1 zone 2 zones 3 zones 4 zones 5 zones 6 zones 7 zones 8 zones 9 zones 10 or more zones

Please remember, all services are continuous from year to year unless Granulawn is notified otherwise.

Again, we would like to thank you for your service and look forward to working with you again in 2011!