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* 1. Name

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* 2. Email

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* 3. Business Name

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* 4. Attendee Description:

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* 5. Zip Code:

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* 6. How did you hear about the Southside Connection Symposium?

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* 7. On a scale from 1-5, how satisfied were you with the keynote conversation?

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* 8. Strengths and/or weaknesses of the keynote conversation:

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* 9. On a scale from 1-5, how satisfied were you with the Executive Leadership Panel?

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* 10. Strengths and/or weaknesses of the panel:

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* 11. Are there any follow-up steps you will take following the Symposium based on the panel or keynote conversation?

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* 12. What content from the Symposium was most helpful to you?

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* 13. What content was least helpful to you?

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* 14. On a scale from 1-5, how satisfied were you with the location of the Symposium (David Rubenstein Forum)?

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* 15. Please rate the day/time of the event on a scale from 1-5.

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* 16. Please rate the registration process for the event.

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* 17. Please provide any comments or suggestions for future event logistics.

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* 18. Would you be comfortable with the SECC sharing your testimonials on social media, our website, etc.?

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* 19. Are you interested in a business consultation?

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