Service/Repair Visit Follow Up
	Please complete the following form and one of our representatives will contact you. Fields marked in bold are mandatory.
	Personal Information First Name Registration Number: Last Name E-mail Address Daytime Phone Number   Evening Phone Number   Delivery Date: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec 2002 2003 2004 2005 2006 2007 2008 2009 2010
	Additional Information
	1. Would you say that you are completely satisfied with the overall experience of your recent service visit?		Yes   No
	2. Was all the work completed first time?		Yes   No
	3. Will you continue to use Gates for future servicing?		Definitely would   Definitely would not
	4. Would you be able to recommend Gates as a place to have a vehicle serviced?		Definitely would   Definitely would not
	5. Your next service is due in 12 months; can we schedule an appointment for you?		Yes   No
	6. In accordance with the Data Protection Act, may we ask for your permission for Gates to contact you again in the future by telephone, post or e-mail (please indicate)?		Telephone   Post   E-mail   No Contact
	If you have any comments you would like to add, please do so here:
	Please indicate if you wish to subscribe to our e-mail updates: Yes   No

Ford Main Dealers for Essex & Hertfordshire, Gates Group was established as one of the first Ford Dealers in the UK back in 1920. Gates continue to be a family owned and operated Company - the current Managing Director representing the fifth generation. Our nine dealer group sell new and second hand cars, Ford Direct used cars & commercial vehicles across Essex and Hertfordshire. We regularly stock in excess of 1,000 used vehicles, and our enormous buying power ensures that our prices are always highly competitive.
Dealerships located in Stevenage, Waltham Cross, Epping, Harlow, Bishops Stortford, Hertford, Letchworth & Dunmow

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Company Name: Frank G Gates Ltd, Company Number: 245843, VAT number: 246 1372 72 Place of Registration: England Registered Office: 33 High Street, Epping, Essex, CM16 4BA