Satisfaction and Refferal Program

Please take the next 5 minutes to reflect on our product and service.

If you choose to participate in our customer referral program you will receive rewards (see below on next page).

Which of the following categories best describes the industry you use Mirametrix eyetracker for?

How would you rate the Mirametrix S2 Eyetracker in terms of

Would you be interested in the ability to use our eye tracker with:

What are other areas of improvement you would like to see for your eyetracking hardware and software?

How would you rate your level of satisfaction with Mirametrix's customer service?

Choose the following qualities that describe Mirametrix:

Optional: Customer Referral Program- Chance to be Rewarded with an S2 Carrying Case and Ipad Mini

If you choose to participate in the Customer Referral Program we would love to reward you for your loyalty and trust in Mirametrix.

If you refer Mirametrix to a friend or colleague, you will receive a high-quality carrying case for your S2 Eyetracker. If your referral becomes a Mirametrix customer, you will receive your very own Apple iPad Mini.

If you would like to take part in our Customer Referral Program, please enter the contact information of your referral(s)

Referral 1:

First Name :
Last Name :
Phone :
Email Address :

Can we mention you as reference?

Yes

No

Referral 2:

First Name :
Last Name :
Phone :
Email Address :

Can we mention you as reference?

Yes

No

Please enter your own

First Name :
Last Name :
Phone :
Email Address :