Date: __________
Name: _____________________________________________
Address: ___________________________________________
City: __________________ State: __________ Zip: _________
Country of Residence: _________________________________
1. Have you placed orders with Island Treasures?

__ no

__ yes

If not, what would encourage you to make a purchase from Island Treasures?

2. Do you like the mailing you receive from Island Treasures?

__ no

__ yes

If not, how would you like to see it changed?

3. Do you like the service you receive from Island Treasures?

__ no

__ yes

If not, what are your specific concerns about our service?

4. Did the quality of the products you've received meet your expectations?

__ no

__ yes

If not, please explain why you were not satisfied.

5. Do you wish to remain on our mailing list?

__ no

__ yes

6. Other comments about our service or products:

Add the following people to your mailing list:

Name: ____________________________ Address: __________________________ City ___________________State_______ Zip code ___________Country_________ Phone (____) _______________________

Name: ____________________________ Address:___________________________ City ___________________State ______ Zip code ___________Country ________ Phone (_____) _____________________

Island Treasures Home Page

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Island Treasures Personal Items

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Island Treasures Household Page

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Island Treasures Gift Items Page One

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Island Treasures Gift Items Page Two

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Island Treasures Gift Items Page Three

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Island Treasures Order Form

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Last updated: 24-June-06