Customer Satisfaction Survey

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Customer Satisfaction Survey

Before completing the survey please provide the folowing information. Fields market with an astrisk (*) are required.

Mandatory *

Order Date (mm/dd/yyyy) * :
Youy must enter order date
State * :	You must select US State
Name * :
your name YOu must enter Your name
Company :
You must enter your company name
Did you receive exactly what you ordered ? * :	Yes No Field not valid (required or bad value)
How would you rate the time it took to receive your order ? * :	Excelent Very Good Good Fair Poor you must enter all mandatory ( * ) fields
What condition was your product in when you received it ? * :	Excellent Very Good Good Fair Poor You must enter all mandatory information
How would you rate the sales representative you spoke with when placing your order ? * :	Excelent Very Good Good Fair Poor not applicable - placed order online You must enter all mandatory information
How would you rate your overall experience with our company on this purchase order ? :	Excelent Very Good Good Fair Poor You must enter all mandatory information
How likely is it that you would recommend Shamrock Marketing & our products to a colleague or associate within your industry ? :	1 2 3 4 5 6 7 8 9 10 Field not valid (required or bad value)

11206 Bluegrass Parkway, Louisville, KY 40299 Tel. (502)266-7403 or 1-800-354-4495 Fax. (502)266-7405 or 1-800-354-4471

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