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North America - Product Trial Feedback Survey
**Please complete on computer or mobile device.
1.
Name
2.
Company
*
3.
Job Title / Position
(Required.)
4.
Location (City, State)
*
5.
Tenure
(Number of years / months with company)
(Required.)
0
50
Clear
*
6.
Current Product Used
[Manufacturer (Brand) Name]
(Required.)
*
7.
Current Product Used
[Manufacturer Model #]
(Required.)
8.
Current Product Used
[Insert Images or Files]
Choose File
No file chosen
*
9.
Tilsatec Product Trialed:
(Required.)
*
10.
How would you rate the Tilsatec product?
(Required.)
Excellent
Good
Poor
Other (please specify)
*
11.
Can you do your job with the Tilsatec product?
(Required.)
Yes
No
12.
General Comments, Suggestions, Ideas, etc.?
13.
Add any pertinent Images and/or Files
(Wear spots, area hazards, etc...)
Choose File
No file chosen
