Coffee Subscription Survey

Question Title

* 1. Are you a current subscriber to our coffee subscriptions?

Yes

Question Title

* 2. Which coffee would you like delivered?

Costa Rica (LIGHT-roasted, fruity, slightly acidic)

Black Velvet Blend (Our most popular blend. MEDIUM-roasted African, Indonesian, Central American beans blended then roasted for a smooth, low acid taste)

Nicaragua (DARK-roasted, full-bodied and smooth, these beans are sourced through their-buckscoffee.com to support direct-trade practices for Organic, family-based farming)

Mexico (Rich, robust and DARK-roasted beans sourced from the finest fincas in Mexico. Hints of unsweetened cocoa, very smooth)

Espresso Blend (Our proprietary blend selected to be sweet, robust and dark)

Question Title

* 3. Do you want your coffee ground or whole bean?

whole bean

very fine grind

fine grind

medium grind

course

Question Title

* 4. Is this purchase for: (does not effect price)

Gift

Personal use

Business

Question Title

* 5. How often would you like delivery?

Four bags per month $60

Three bags per month $45

Two bags per month $31

Two bags in 90 days $32

one bag per month $16

one bag every 90 days $16

One bag every two months $16

one time purchase $16

Question Title

* 6. Do you want autopay or to pay for each delivery?

Autopay (2% discount)

Billing

Question Title

* 7. Please enter your contact information including phone number. For security we will only CALL you for billing information.

Name

Shipping Address

Shipping Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 8. Thank you very much for your business. We will call you soon for billing information. Please rate this questionnaire for simplicity.

Difficult to complete/understand

Easy to complete/understand

Difficult to complete/understand

Easy to complete/understand