Form Number: CD17 (Feedback on the services provided by RCCs)

Name of person giving feedback:
Contact Details:
- Telephone Number:
- Address:
Name of Co-operative Society/Organization:




1. How do you find the services provided by the officers at the above mentioned Regional Co-operative Centre? (Select where appropriate)
                                                     

   Very Good	Good
   Satisfactory	Poor



2. Have you encountered any problem/difficulty at the above mentioned Regional Co-operative Centre? (Indicate Yes/No).

   Yes No

   
   If yes, specify the problem/difficulty below:
   
   



3. Suggest any probable solution/s to the problem/difficulty mentioned at paragraph 5. (Please be explicit).
   
   



4. Which services provided by the above mentioned RCC have you appreciated? (Please specify).
   
   



5. State any comment/proposition to improve the services provided at the above mentioned RCC :
   
   


Date of submission:  





NOTE FOR CUSTOMERS:   Your feedback on our services at Regional Co-operative Centres is very important as this will help us improve our work and satisfy your requirements in a better way.





Thank you for filling this questionnaire.