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Revision of
Test Webform
from
Thu, 19/04/2012 - 9:00pm
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Test Webform
Confidential
Contact Info
Customer Company Name:
*
- Select -
abc
xyzz
Please fill this form only after you have defined your customer under contacts.
Desgination:
Contact Person Name:
*
Date:
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
2022
2023
2024
2025
2026
How long have you been our customer?:
Less than 6 months
6 months-1 year
2-3 years
4-5 years
More than 5 years
How satisfied are you with our products/services?:
*
Very Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Very Dissatisfied
Please rate our company on the following attributes::
*
Very Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Very Dissatisfied
Friendliness of our staff
Knowledge of our staff
Quality of Services
Our Pricing
Meeting completion date
Workmanship and attention to detail
Would you recommend our company's product/service to others?:
*
Yes
No
Maybe
Which Department of our Company would you suggest requires improvement:
Customer Service
Designing
Production
PRODUCTION
Purchase
Sale
Training
Select one or multiple departments as needed.
Which product/service you prefer purchasing from us:
Software
Please provide any suggestion for improvement of our product/services::
Remarks
Overall Satisfation Rating:
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