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How often do you conduct surveys?
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
Other
 
 
 
 
What types of credit cards do you have (Select all that apply)?
 
Visa
 
Mastercard
 
American Express
 
Discover
 
Diners Club
 
Other
 

 
 
 
How often do you conduct surveys?
 
 
 
Comments/Suggestions text :
   
 
 
 
First Name : 
Last Name : 
Address 1 : 
Address 2 : 
City : 
State : 
Zip : 
Phone : 
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
 
 
 
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
     
     
     
    Please allocate 100 points on how you spend your income:
    Essentials (Gas, Grocery etc.)
    Entertainment (Movies, Clubs etc.)
    Other
    0
     
     
    Please rate the following:
    Books
    Movies
    Music
     
     
     
    How satisfied are you with our services?
    Very Unsatisfied
    Unsatisfied
    Neutral
    Satisfied
    Very Satisfied
     
     
     
    What do you think of Starbucks?
    Love it
    Hate it
     
     
     
    How often do you conduct surveys?
    one
    two
    three
     
     
     
    What types of credit cards do you have (Select all that apply)?
    option 1
    option 2
    option 3

     
     
    How satisfied are you with the following:
    select 1
    select 2
    select 3
     
     
    Please rate your video
    Comments
     
     
     
    Descriptive / Spacer Text Here
     
     
     
     
    Descriptive / Spacer Text Here
     
     
     
    Descriptive / Spacer Text Here
     
     
     
    What is your date of birth?
    MonthDayYearHrs.Mins.AM/PM
        
     
     
     
    What is your date of birth?
     
     
     
    ImportanceSatisfaction
    Not ImportantVery Important
    Not SatisfiedVery Satisfied
    1234512345
    Customer Service
    Product Packaging
    On-Time Arrival
     
     
     
    Matrix table[left,right]
    12345
    Product Packaging
    On-Time Arrival
    Price
     
     
     
    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:
    leftright
    Website
    -
    Customer Service
    -
    Overall
    -
     
     
    How satisfied are you with the following:
    Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
    Website
    -
    Customer Service
    -
    Overall
    -
     
     
     
    Search the location of your store
     
     
     
    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.
     
     
    * Enter a valid zip code
     
     
     
    * Upload your file below
     
     
     
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