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* 1. How often do you place an order with Sirchie?

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* 2. Please provide your current contact information:

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* 3. Who makes the purchasing decision in your organization?

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* 4. Please rate your satisfaction with Sirchie in the following areas:

  Excellent Above Average Average Below Average Very Poor
Overall satisfaction
Prices
Quality
Customer Service
Delivery

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* 5. When making a purchase, what is most important to you? Rank 1-4, with 1 being most important and 4 being least important.

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* 6. Which professional and trade publications and / or visit websites for news or to learn about products, insights or other profession-related information? Select all that apply.

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* 7. How would you rate your Account Representative in the following?

  Excellent  Above Average  Average  Below Average  Very Poor
Knowledgeable about products
Responds to questions in a timely manner
Is Professional and Courteous
Is concerned about my organizations needs

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* 8. Have you ever attended a Sirchie training course? If yes, check all that apply.

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* 9. How do you prefer to have Companies communicate with you? Select all that apply. 

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* 10. What products are you interested in? Check all that apply

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* 11. Legal Notice: If your name is selected in our Customer Satisfaction Survey Drawing for a Gift Card, please confirm whether your department / school allows you to receive gifts.

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