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* Please drag and rank(1st to 3rd) the following in order of interest:
Drag your choices here to rank them
     
     
     
    * Please rank (1-3) the following in order of interest:
    Skiing
    Snowboarding
    Biking
     
     
    * How satisfied are you with the following:
    visa
    amex
     
     
     
    * Please sign here
     
     
     
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    * 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
     
     
    * 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.
     
     
     
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    * Comments/Suggestions:
       
     
     
     
    * Please select the state you live in.
     
     
     
    ImportanceSatisfaction
    Not ImportantVery Important
    Not SatisfiedVery Satisfied
    1234512345
    * Customer Service
    * Product Packaging
    * On-Time Arrival
     
     
    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
     
     
     
    * Comments/Suggestions:
       
     
     
     
    * First Name : 
    * Last Name : 
    * Address 1 : 
       Address 2 : 
    * City : 
    * State : 
    * Zip : 
    * Phone : 
    * Email Address : 
     
     
     
    * How often do you conduct surveys?
     
     
     
    * What types of credit cards do you have (Select all that apply)?
    visa
    master
    amc
    disc

     
     
     
    * What is your date of birth?
    MonthDayYear
      
     
     
     
    * How likely would you be to recommend our products to a friend or colleague?
    «Very UnlikelyVery Likely»
    012345678910
     
     
    How satisfied are you with the following:
    * Website
    -
    * Customer Service
    -
    * Overall
    -
     
     
     
    * How satisfied are you with our services?
    Very Unsatisfied
    Unsatisfied
    Neutral
    Satisfied
    Very Satisfied
     
     
    Please rate the following:
    * Books
    * Movies
    * Music
     
     
     
    * 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?
    visa
    master