* First name

* Surname

* Gender

Male Female

* Address

Address 2

Address 3

* Town

* Postcode

* Home Phone number

* Mobile phone number

* Email address

* Age

16-25 26-35 36-45 46-55 56-64 65 and over

* Marital status

single married civil partnership divorced/civil partnership dissolved widowed

* How far, approximately, did you travel to visit?

Up to 1 mile 1-2 miles 3-5 miles 5-10 miles 10-20 miles over 20 miles

* What means of transport do you normally use to come here?

bus train car tram bicycle moped/motorbike foot

* How often do you visit?

daily 3-5 times a week 1-2 times a week 1-3 times a month a few times a year

* What is your favourite shop?

* What could we provide that would make you inclined to visit more often?

* What stores do you typically shop at while visiting us?

* What stores would you like to see