Dear Customer:
Please select the seminar you are attending today:
-- Select -- [SEMINAR TOPIC 1] [SEMINAR TOPIC 2] [SEMINAR TOPIC 3] [SEMINAR TOPIC 4]
Name:
Company:
Street Address
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State
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Email Address
Please select your gender:
Please select your age group:
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Please select your occupation:
-- Select -- Computer Tech. Education Engineering Professional Production Worker Salesperson Finance Human Resources/Training Legal First-Line Supervisor Customer Service Rep. Executive Manufacturing Marketing/Advertising Medical Middle Management Senior Manager Administrative Employee Sales Services Other
Do you have people that report to you? If yes, how many?
Highest Level of Education Completed:
Current Annual Household Income (Optional):
-- Select -- up to 20,000 20,001 - 40,000 40,001 - 60,000 60,001 - 80,000 80,001 - 100,000 100,001 - 150,000 150,001 - 200,000 200,001 - 250,000 250,000 or over
What were your criteria for selecting to attend this particular seminar? (Select the most important one)
How far did you travel to today's seminar?
How did you pay for today's seminar?
What other seminars did you attend? (Select all that apply):
What types of credit cards do you have (Select all that apply)?
What other seminars are you interested in attending? (Select all that apply):
Where did you initially hear about this seminar? (Select one):
Did you make the decision to attend today's seminar?
Thank you for your feedback. We sincerely appreciate your honest opinion and will take your input into consideration while providing products and services in the future.
