Customer Win-Back Offer Form

Customer Win-Back Offer Form — Form Fields

This marketing template includes 7 fields. A customer win-back form to re-engage churned or inactive customers. Captures feedback on why they left and presents retention offers to bring them back. Free to customize and use on ZenBuild.

• Full Name (text, required)
• Email Address (email, required)
• Primary Reason You Left (dropdown selection, required) — options: Price was too high, Found a better alternative, Missing features I needed, Poor customer support experience, No longer needed the product, Other
• What could we have done better? (long text, optional)
• Which offer would interest you most? (multiple choice, required) — options: 30% off for 3 months, Free month to try new features, Complimentary onboarding session, Extended free trial
• How likely are you to give us another try? (1 = unlikely, 5 = very likely) (rating, required)
• What improvements would bring you back? (checkboxes, optional) — options: Better pricing, New features, Improved support, Better user experience, More integrations