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  2. 2015
  3. April
  4. A
  5. all question types - Languages
0%
Questions marked with an * are required Exit Survey
 
 
* Single select
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
 
 
* Select many
 
Visa
 
Mastercard
 
American Express
 
Discover
 
Diners Club

 
 
 
ImportanceSatisfaction
Not ImportantVery Important
Not SatisfiedVery Satisfied
1234512345
Customer Service
Product Packaging
On-Time Arrival
 
 
 
ImportanceSatisfaction
Not ImportantVery Important
Not SatisfiedVery Satisfied
123456123456
Customer Service
Product Packaging
On-Time Arrival
treast
 
 
 
* Drop down
 
 
 
* Comment box
   
 
 
 
* Comment box with 2 boxes
   
* This is the second box
   
 
 
 
* Single row text
   
 
 
 
* Single row text 2 box
   
* second box
   
 
 
 
* Numeric input
   
 
 
 
* Numeric input 2 boxes
   
* This is the second box
   
 
 
 
* Email Address
   
 
 
 
* Email Address with 2 boxes
   
* Second box
   
 
 
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:
LeftRight
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied N/A
* Website
* Customer Service
* Overall
 
 
How satisfied are you with the following:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied NA
* Website
* Customer Service
* Overall
 
 
How satisfied are you with the following:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied N/A
* Website
* Customer Service
* Overall
 
 
 
* Please rank (1-3) the following in order of interest:
Skiing
Snowboarding
Biking
 
 
 
* Please drag and rank(1st to 3rd) the following in order of interest:
Drag your choices here to rank them
     
     
     
    * Please allocate 100 points on how you spend your income:
    Essentials (Gas, Grocery etc.)
    Entertainment (Movies, Clubs etc.)
    Other
    0
    Values must add up to 100
     
     
     
    * Constant sum of 200
    Essentials (Gas, Grocery etc.)
    Entertainment (Movies, Clubs etc.)
    Other
    0
    Values must add up to 100
     
     
     
    * How satisfied are you with our services?
    Very Unsatisfied
    Unsatisfied
    Neutral
    Satisfied
    Very Satisfied
     
     
    Please rate the following:
    * Books
    * Movies
    * Music
     
     
     
    Descriptive / Spacer Text Here
     
     
     
     
    Descriptive / Spacer Text Here
     
     
     
    Descriptive / Spacer Text Here
     
     
     
    * What is your date of birth?
     
     
     
    * What is your date of birth? with time
    MonthDayYear
      
     
     
     
    * First Name : 
    * Last Name : 
    * Address 1 : 
       Address 2 : 
    * City : 
    * State : 
    * Zip : 
    * Phone : 
    * Email Address : 
     
     
     
    ImportanceSatisfactionLevity
    Not ImportantVery Important
    Not SatisfiedVery Satisfied
    LightHeavey
    123451234512345
    * Customer Service
    * Product Packaging
    * On-Time Arrival
     
     
    How satisfied are you with the following: Numerical
    leftright
    * Website
    -
    * Customer Service
    -
    * Overall
    -
     
     
    How satisfied are you with the following: max is 40 min is 10
    * Website
    -
    * Customer Service
    -
    * Overall
    -
     
     
    How satisfied are you with the following:
    Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
    * Website
    -
    * Customer Service
    -
    * Overall
    -
     
     
     
    * How often do you conduct surveys?
    android
    something
    War
     
     
     
    * What types of credit cards do you have (Select all that apply)?
    thingy
    thingy2
    chat
     
     
    * How satisfied are you with the following:
    sky
    really?
    flowers
     
     
    * Enter a valid zip code
     
     
     
    * Please select the state you live in.
     
     
    * 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.
     
     
     
    * Upload your file below
     
     
     
    * Upload your file below siggy
     
     
     
    * How likely would you be to recommend our products to a friend or colleague?
    «Very UnlikelyVery Likely»
    012345678910