Retail Price Survey Assignment Form
Please complete the following assignment details for the retail price survey. All fields are required for accurate survey tracking and analysis.
Surveyor Name
*
First Name
Last Name
Store Name
*
Store Location (City)
*
Date of Visit
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Product Category
*
Please Select
Beverages
Snacks
Personal Care
Household
Other
Which competitor stores did you compare prices with?
*
Store A
Store B
Store C
Other
Please rate the ease of collecting price data at this store.
*
Very Difficult
1
2
3
4
Very Easy
5
1 is Very Difficult, 5 is Very Easy
Overall store experience
*
1
2
3
4
5
Product Price Comparison Table
*
Rows
Store Surveyed
Your Price
Competitor Price
Product 1
Product 2
Product 3
Additional Comments or Observations
Submit Survey
Should be Empty: