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Thank you for agreeing to take the [Company] customer survey. All the answers you provide are anonymous and confidential.

1. What best describes your employment status?
2. What best describes your level of education?
3. In which industry do you work?
4. Which of the following best describes your job role?
5. What is your job title?
6. How long have you worked for your current company?
7. How large is your current company?
8. What is the annual revenues of your company?
9. Where is your company located? If you work in a branch office, please provide that location.
City
State/Region
Zip/Postal Code
10. Which of the following includes your age?
11. Which of the following best describes your ethnicity?
12. What is your gender?
13. How long have you been a customer of our company?
14. Overall, how satisfied are you with our products/services?
  Very SatisfiedSomewhat SatisfiedNeutralSomewhat DissatisfiedVery Dissatisfied
 
15. If our company could improve in one way, what would you find to be most valuable?
Thank You!

Thank you for taking our survey. Your feedback is very important to us.