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  1. Surveys
  2. 2015
  3. November
  4. A
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Exit Survey
 
 
How often do you conduct surveys?
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
 
 
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?
 
 
 
What types of credit cards do you have (Select all that apply)?
Visa
Mastercard
Discover
Diners Club
 
 
 
What credit card you prefer most ?
Master card
American Express
Diners Club
 
 
How satisfied are you with the following:
 
 
 
How often do you conduct surveys?
 
 
 
Comments/Suggestions:
   
 
 
 
Name
   
 
 
 
How many months have you been at your current residence?
   
 
 
 
Email Address
   
 
 
How satisfied are you with the following:
Yes No Maybe
Website
Customer Service
Overall
 
 
How satisfied are you with the following:
Yes No NA
Website
Customer Service
Overall
 
 
How satisfied are you with the following:
Yes No Maybe
Website
Customer Service
Overall
 
 
 
ImportanceSatisfaction
Not ImportantVery Important
Not SatisfiedVery Satisfied
123123
Customer Service
Product Packaging
On-Time Arrival
 
 
How satisfied are you with the following:
Website
Customer Service
Overall
 
 
How satisfied are you with the following:
Yes No Maybe
Website
-
Customer Service
-
Overall
-
 
 
How satisfied are you with the following:
Website
-
Customer Service
-
Overall
-
 
 
 
Please rank (1-4) the following in order of interest:
Drag your choices here to rank them
     
     
     
    What do you think of Starbucks?
    Like it
    Dislike it
     
     
     
    How satisfied are you with our services
    Extremely Unsatisfied 123456
    Unsatisfied 123456
    Neutral 123456
    Satisfied 123456
    Extremely Satisfied 123456
     
     
     
    Please rank (1-3) the following in order of interest:
    Skiing
    Snowboarding
    Biking
     
     
     
    Please allocate 100 points on how you spend your income:
    Essentials (Gas, Grocery etc.)
    Entertainment (Movies, Clubs etc.)
    Other
    0
     
     
     
    What is your date of birth? ( mm-dd-yyyy)
    MonthDayYear
      
     
     
     
    What is your date of birth? (mm-dd-yyyy - 24hr)
    MonthDayYearHrs.Mins.
       
     
     
     
    What is your date of birth? (dd-mm-yyyy)
    DayMonthYear
      
     
     
     
    What is your date of birth? (dd-mm-yyyy - 24hr)
    DayMonthYearHrs.Mins.
       
     
     
    Contact Information
    First Name : 
    Last Name : 
    Email Address : 
     
     
     
    Select Captcha and Verify :
       
     
     
     
    What is your date of birth? (mm-dd-yyyy)
     
     
     
    What is your date of birth? (dd-mm-yyyy)
     
     
     
    What is your date of birth? (month dd,yyyy)
     
     
     
    Considering your complete experience with our company, how likely would you be to recommend our products to a friend or colleague?
    «Very UnlikelyVery Likely»
    012345678910
     
     
    At what price would you consider the Product
    $1000 - $12000 $1200 - $15000 $1500 - $25000 $2500 - $35000 $3500 - $50000
    At what price is the product too expensive to consider? (Too Expensive)
     
    At what price is the product so cheap that the product quality is questionable? (Too Inexpensive)
     
    At what price does the product begin to seem too expensive? (Expensive)
     
    At what price is the product a bargain? (Inexpensive)
     
     
     
    For each transportation category in the table below, please indicate what percentage, if any, of the need you would fund
    Total Needed
    PER YEAR    		Cost to
    Fund 100%
    PER MONTH
    Preservation and maintenance of existing transport system
    -
    		 1000.0 10
    Adding new lanes and expanding road and bridge capacity
    -
    		 2000.0 20
    Increasing transit service and expanding passenger and freight rail
    -
    		 3000.0 30
    Making bike and sidewalk improvements
    -
    		 4000.0 40
    Replacing obsolete ferries and improving ferry terminals
    -
    		 5000.0 50
     
     
     
    Descriptive/Spacer Text Here :
     
     
     
     
    Descriptive/Spacer Text Here : section heading
     
     
     
    Descriptive/Spacer Text Here : Sub heading
     
     
    Step 1 of 1
    For each of the questions below, please choose your most and least preferred option
    MostLeast

    Visa

    Mastercard

    Discover

    American Express
     
    Step 1 of 2
    If you were to buy a TV, select the most likely feature set you would go with:
    Brand LG Vizio Sony Sony
    PriceUSD 1,200.00USD 800.00USD 1,500.00USD 800.00
    Size45''36''32''45''
     
     
    Video. Moment by moment.
     
     
     
       
       
      Video. Cue-point
       
       
       
         
         
         
        Please drag/ crop the area of your interest on the image:
         
         
         
        Please like/dislike predefined selected areas on the image considered for Hot Spots:
         
         
         
        How much time does it take you to shop for groceries?
           
         
         
         
        Please scan the Barcode.
           
         
         
         
         
           
         
         
         
        Upload your file below. photo
         
         
         
        Upload your file below. video
         
         
         
        Upload your file below. Audio
         
         
         
        Please sign here
         
         
        Complex Grid / Flex Matrix
          
        left right
        Product Packaging
        On-Time Arrival
        Price
         
         
         
        Enter in your salary: Smart Validator
        Base $
        Bonus/Commission $
         
         
        Please enter in info to join the community :
        First Name : 
        Last Name : 
        Email Address : 
         
         
        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 Captcha and Verify
           
         
         
         
        Please allocate 100 points on how you spend your income:
        Essentials (Gas, Grocery etc.)
        Entertainment (Movies, Clubs etc.)
        Other
        0
         
         
        Please click/tap on any areas of discomfort