Customer Survey Question Title 1. Based on your experience with Hometown, how likely are you to use us again? Definitely Very likely Probably Not likely Not a chance Definitely Very likely Probably Not likely Not a chance Question Title 2. How likely are you to refer our company to your family, friends, or neighbors? Definitely Very likely Probably Not likely Not a chance Definitely Very likely Probably Not likely Not a chance Question Title 3. Please check the Hometown programs that you are most familiar with: Auto-Fill SmartPay/Budget Billing Cap Price Protection Fixed Price Protection Prebuy Question Title 4. Please check the program(s) you would like to learn more about: Auto-Fill SmartPay/Budget Billing Cap Price Protection Fixed Price Protection Prebuy Question Title 5. Please share how you originally became acquainted with Hometown: Mailer Referral Billboard Facebook Google Yellow Pages Local newspaper ad Mailer Referral Billboard Facebook Google Yellow Pages Local newspaper ad Other (please specify) Question Title 6. Additional Comments: Question Title 7. Submitted by: *First and Last Name * *Street Address * *City * *State * *ZIP * *Email Address * Phone Number Submit
