Branch Location

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* 1. Branch Location

Member Name (information required to qualify for quarterly drawing)

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* 2. Member Name (information required to qualify for quarterly drawing)

What type of transaction did you conduct today?

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* 3. What type of transaction did you conduct today?

Who assisted you today? (If name unknown please reference your receipt for the Teller (Tlr) #)

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* 4. Who assisted you today? (If name unknown please reference your receipt for the Teller (Tlr) #)

Please rate your overall experience below:

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* 5. Please rate your overall experience below:

  Exceptional Good Fair Poor
Friendly and Courteous Manner
Please rate your overall experience below:

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* 6. Please rate your overall experience below:

  Exceptional Good Fair Poor
Knowledge of Products and Services
Please rate your overall experience below:

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* 7. Please rate your overall experience below:

  Exceptional Good Fair Poor
Willingness to listen and respond to your needs
Please rate your overall experience below:

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* 8. Please rate your overall experience below:

  Exceptional Good Fair Poor
Professionalism
Did the Member Service Representative offer you other products or services to meet your needs or enhance your banking experience?

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* 9. Did the Member Service Representative offer you other products or services to meet your needs or enhance your banking experience?

We sincerely value your opinion, would you refer your Friends and Family to Five County Credit Union?

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* 10. We sincerely value your opinion, would you refer your Friends and Family to Five County Credit Union?

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