Customer Feedback Form on the services provided at
Regional Co-operative Centre (RCC)

Telephone Number (optional):

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

  1. Name of person giving feedback:
  2. Contact Details:
  3. - Telephone Number:
    - Address:
  4. Name of Co-operative Society/Organization:

  5. 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

  6. 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:

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

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

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

  10. 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.