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* 1. First Name:

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* 2. Last Name:

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* 3. Phone Number:

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* 4. Email:

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* 5. Mailing Address:

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* 6. Delivery Date:

Date machine was delivered

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* 7. Did you receive your Operator's Manual?

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* 8. Are you satisfied with the Set-Up and Delivery of this equipment?

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* 9. Overall, how would you rate your satisfaction with our dealership for this purchase?

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* 10. CEC Location:

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* 11. Salesperson's Name:

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* 12. How did you hear about us?

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* 13. Please check all items you'd like to learn more about:

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* 14. Additional Comments:

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