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How long have you been purchasing our services?
 
Less than 6 months
 
6 months to less than 1 year
 
1 year to less than 3 years
 
3 years to less than 5 years
 
5 years or more
 
 
How often do you use our services?
Don't Use Daily Weekly Monthly Quarterly
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Where do you purchase our services?
 
In our store
 
Online
 
Telephone order/catalogue
 
Through a dealer
 
Through an agent
 
Through a wholesaler
 
Other
 
 
 
 
How would you rate your overall level of satisfaction with us?
 
Highly satisfied
 
Somewhat satisfied
 
Neutral
 
Somewhat dissatisfied
 
Highly dissatisfied
 
 
How do we rate on the following attributes?
Well Below Average Below Average Average Above Average Well Above Average
Customer service experience
On-time delivery of service
Professionalism
Purchase experience
Quality of service
Understanding of customers' needs
 
 
 
How do we rate in comparison to other companies that offer the same services?
 
Much higher
 
Somewhat higher
 
Same
 
Somewhat lower
 
Much lower
 
Don't know
 
 
 
How likely are you to continue using our services?
 
Very likely
 
Somewhat likely
 
Neutral
 
Somewhat unlikely
 
Very unlikely
 
 
 
Have you ever recommended us to others?
 
No, never recommended
 
Have recommended once or twice
 
Have recommended several times
 
 
 
Do you have any suggestions for improvement?
   
 
 
 
What is your gender?
 
Male
 
Female
 
Prefer not to answer
 
 
 
What is your age?
 
Younger than 18
 
18 - 24
 
25 - 34
 
35 - 44
 
45 - 54
 
55 - 64
 
65 or older
 
Prefer not to answer
 
 
 
What best describes your employment status?
 
Employed full-time
 
Employed part-time
 
Self-employed
 
Unemployed, looking for work
 
Unemployed, not looking for work
 
Student
 
Retired
 
Homemaker
 
Military
 
Prefer not to answer
 
Other
 
 
 
 
Which of the following categories best describes your annual income?
 
Under $15,000
 
$15,000 - $29,999
 
$30,000 - $44,999
 
$45,000 - $59,999
 
$60,000 - $74,999
 
$75,000 - $89,999
 
$90,000 or more
 
Prefer not to answer
 
 
 
What year of school are you in?
 
Freshman
 
Sophomore
 
Junior
 
Senior
 
Graduate student
 
 
 
Was the difficulty of the course in line with your expectations?
 
Yes
 
No
 
Maybe
 
 
 
Would you recommend this course to other students?
 
Yes
 
No
 
 
 
If no, why not?
   
 
 
 
Would you take another course taught by this professor?
 
Yes
 
No
 
Maybe
 
 
 
In what ways could this course be improved?
   
 
 
 
Rate the amount of work you did
 
Almost none
 
What was assigned
 
More than just what was assigned
 
 
 
Rate the level of your involvement in the activities of this course.
 
Very uninvolved
 
Somewhat involved
 
Enthusiastically involved
 
 
 
How much practical knowledge have you gained from this course?
 
A great deal
 
Some practical knowledge
 
None
 
 
 
II. General Evaluation of the Course
 

Strongly Agree Agree Neutral Disagree Strongly Disagree
The course objectives where clear
The course procedures and assignments support course objectives
The amount of reading you were asked to do was appropriate
The amount of writing or other class work you were asked to do was enough
 
 
 
What overall rating would you give the course?
 
Excellent
 
Good
 
Average
 
Poor
 
Very Poor
 
 
 
What are the major strengths of this course?
   
 
 
 
What are the major weaknesses of this course?
   
 
 
 
III. General Evaluation of the Instructor
 
 
Never Sometimes Usually Most of the time Always
Could you get clear answers to your questions from the instructor?
Was the instructor considerate to you?
Was the instructor effective in teaching in the course?
Was the instructor enthusiastic about the course?
 
 
 
What overall rating would you give the instructor?
 
Excellent
 
Good
 
Average
 
Poor
 
Very poor
 
 
 
What would you recommend to improve the instructor's performance?
   
 
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