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Model Corporate Offices
100 Third Street
Charleroi, PA 15022-1524
888-99-MODEL (66335)
724-489-9553
724-489-4386 Fax
info@modelcleaners.com

Let us Make Your Life Wrinkle-Free

First Name: *
Last Name: *
Street Address: *	,
Telephone: *
Email Address: *

Optional Information:
If you'd like to receive periodic, personalized offers, coupons, rebates, seasonal promotions, contest information and more, simply complete the rest of this questionnaire. Model Cleaners will send you the information that fits your dry cleaning needs and preferences.

Your information will be kept private. For more information, pleae read our privacy policy.

Gender

Male Female

Birth date (Month & Day Only)

Age Group

18-24 25-40 41-54 55+

Household income.

Up to $45K $45K to $75K Over $75K

How often do you use dry cleaning services?

Weekly Every other week Monthly

Check the three types of articles that you have dry cleaned most often?

shirts pants suits skirts dresses
blouses gowns sweaters coats/jackets
leathers/suedes blankets/bedspreads
comforters tableclothes drapes

Are you a current Model Cleaners user?

Yes No

If yes, how do you use our services?

walk-in drive-thru online

How much dry cleaning do you purchase per month?

How did you first hear about Model Cleaners?

Newspaper Radio TV Billboard
Friend Internet Saw Your Van

Favorite radio station? (fill in)

Favorite TV program? (fill in)

Rank the following as they apply to your choice of a dry cleaner.

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