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FEEDBACK.DOC
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1990-11-08
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Customer Feedback Document
Please use this form to report any difficulties or offer any suggestions
you may have regarding this product. Thank you for taking your valuable
time to assist us in this manner.
Product Name _____________________________________ Version _____________
Your Name ______________________________________________________________
Address ______________________________________________________________
______________________________________________________________
City _________________________________ State ______ Zip ___________
Phone ______________________________________________________________
Computer ________________________________________ DOS Level ___________
Nature of Feedback: Problem Report( ) Feature Suggestion( ) Other( )
Specific Problem/Request _______________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
(Please describe exact activity when encountering problem)
Additional Comments ___________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
(Use Back of form or additional sheets as needed)
Mail To: Torbert Data Systems, Inc.
Post Office Box 9218
Chesapeake, VA 23321