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2012
July
T
task11
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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?
-- Select --
Weekly
Monthly
Quarterly
Annually
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
-- Select --
1
2
3
Snowboarding
-- Select --
1
2
3
Biking
-- Select --
1
2
3
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?
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Jan
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Jun
Jul
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Oct
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Dec
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2024
Contact Information
*
First Name
:
*
Last Name
:
*
Email Address
:
Importance
Satisfaction
Not Important
Very Important
Not Satisfied
Very Satisfied
1
2
3
4
5
1
2
3
4
5
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.
-- Select --
Mountain West
West
Considering your
complete
experience with our company, how likely would you be to recommend our products to a friend or colleague?
«Very Unlikely
Very Likely»
0
1
2
3
4
5
6
7
8
9
10
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