Bridge City Mall Survey
Daily Prize Draw of R100 Vouchers
Stand a chance to win R100 vouchers every day!
Cellphone Number (Number we will call to confirm prize) *
First Name *
Last Name *
How old are you? *
Are you... *
How Satisfied are you with the Wi-Fi *
Not Satisfied at all
Very Satisfied
I use the Free Wi-Fi mostly for... *
How often did you use the Free Wi-Fi during the last month *
Currently, are you... *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy