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What is your gender?
 
Male
 
Female
 
 
 
What types of credit cards do you have (Select all that apply)?
 
Visa
 
Mastercard
 
American Express
 
Discover
 
Diners Club

 
 
 
How often do you conduct surveys?
 
 
 
Comments/Suggestions:
   
 
 
 
Name
   
 
 
 
How long have you been at your current residence?
   
 
 
 
Email Address
   
 
 
How satisfied are you with the following:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
Website
Customer Service
Overall
 
 
How satisfied are you with the following:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
Website
Customer Service
Overall
 
 
How satisfied are you with the following:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
Website
Customer Service
Overall
 
 
 
Descriptive/Spacer Text Here
 
 
 
Please rank (1-3) the following in order of interest:
Skiing
Snowboarding
Biking
 
 
 
Please allocate 50 points on how you spend your income:
Essentials (Gas, Grocery etc.)
Entertainment (Movies, Clubs etc.)
Other
0
 
 
 
What is your date of birth?
 
 
Contact Information
* First Name : 
* Last Name : 
* Email Address : 
 
 
 
ImportanceSatisfaction
Not ImportantVery Important
Not SatisfiedVery Satisfied
1234512345
Customer Service
Product Packaging
On-Time Arrival
 
 
How satisfied are you with the following:
Website
-
Customer Service
-
Overall
-
 
 
 
How often do you conduct surveys?
QP
SA
QS
 
 
* Enter a valid zip code
 
 
Please select an option from the drop down menu below. After selecting an option, another drop down list will be displayed below. Select an appropriate option from that list as well.
 
 
 
Considering your complete experience with our company, how likely would you be to recommend our products to a friend or colleague?
«Very UnlikelyVery Likely»
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