Shareholder Information Update Section 1: Shareholder Information Question Title * 1. Shareholder Name Question Title * 2. Named Representative (If an individual, please put "Self") Question Title * 3. Named Representative's Title Question Title * 4. Named Representative's Contact Information Address * Address 2 City/Town * State/Province * ZIP/Postal Code * Country Email Address * Daytime Phone Number Question Title * 5. Named Representative's Birthday (MM/DD) Section II: Questionnaire Question Title * 6. How connected do you feel to Southern? (1-not connected at all, 10-extremely connected) 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 Question Title * 7. How connected do you feel to Southern mission? (1-not connected at all, 10-extremely connected) 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 Question Title * 8. How often do you receive contact from Southern? Always (3+ times/week) Usually (1-3 times/week) Sometimes (1-2 times/month) Rarely (1-2 times/year) Never Question Title * 9. How often would you like to receive contact from Southern? Always (3+ times/week) Usually (1-3 times/week) Sometimes (1-2 times/month) Rarely (1-2 times/year) Never Question Title * 10. Would you be interested in a tour of our market areas? (1-not interested, 10-extremely interested) 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 Done
