Survey Report Fill each section correctly Please enable JavaScript in your browser to complete this form.1Tester's Bio-data23Name *FirstLastSurvey ID Refer to section 1 of page 2 of the Survey Operational Manual. Skip this section if you're not sure of your ID number.Email *Phone *NextNike Gear Shopping ReportYou are required to fill in information from your survey at Nike store. If you carried out your survey in another store, e.g. Dicks Sporting Goods, fill the box below; else skip the box.Name of Store VisitedFill this box if the survey/purchases was not done in Nike store, else do not fill this box.Address of Nike Outlet Visited.Address Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateFill box if the survey/purchases was done in Nike storeName of Attendant/Cashier/ManagerFill in the name of any of the above staff if you captured their names, else fill in N/A or skipRate customer service of the attending official(s)Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5Image of Apparel 1 Barcode *Capture the barcode area of the Men's Sleeveless Top or Women's Sports Bra purchased and upload the image here.Image of Apparel 2 Barcode *Capture the barcode area of the Men's 2-in-1 Shorts or Women's Full-Length Leggings purchased and upload the image here.Image of Apparel 3 Barcode *Capture the barcode area of the Training Ankle Socks purchased and upload the image here.Image of Apparel 4 Barcode *Capture the barcode area of the Road Running Shoes purchased and upload the image here.Nike Gift Card Sample 1Upload clear images of front and back of the $500 Nike gift card purchased at Nike Store. Ensure to peel the silver seal on the PIN area of the card gently for scanning in the next phase. Front of Gift Voucher Purchased at Nike Outlet *Upload an image of the front side of the gift voucher purchasedBack of Gift Voucher Purchased at Nike Outlet *Upload an image of the rear side of the gift voucher purchasedImage of Receipt Issued at Nike OutletUpload an image of the receipt issued at Nike store for sports gear and gift voucher purchase.Additional Comment/ReportNextCVS/Walmart Gift Voucher Evaluation This section seeks to collect reports with supporting images for CVS/Walmart store evaluation. If a survey was carried out in other stores due to non-availability of the required store or item, kindly proceed with your report.Name of Store Visited *Address of Store Visited.Address Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateIf the purchase or survey was carried out at a store other than CVS/Walmart, enter its address and notify your survey manager of the change.Name of Attendant/Cashier/ManagerFill in the name of any of the above staff if you captured their names, else fill in N/A or skipRate the general condition of Nike vouchers and its related products found in this store.Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5Nike Gift Card Sample 2Upload clear images of front and back of the $500 Nike gift card purchased at CVS, Walmart or any other store. Ensure to peel the silver seal on the PIN area of the card gently for scanning in the next phase. Front Side of Gift Voucher Purchased *Upload an image of the front side of the gift voucher purchasedBack Side of Gift Voucher Purchased *Upload an image of the rear side of the gift voucher purchasedImage of Receipt Issued for Purchases *Upload an image of the receipt issued for the purchaseAdditional Comment/ReportSubmit Report
