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Survey Name Customer Lead and Qualification
Description Customer information and company profile / product use and budget survey.
Category Marketing   (Browse All Categories)

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Please indicate which of the following [Company] products you own:
Company
YesNo
Product 1
Product 2
Product 3
Product 4
Product 5
Product 6
Product 7
 
   
PURCHASE HISTORY

Please indicate when you last purchased a [Company] product?
0-3 months ago
3-6 months ago
6-12 months ago
12-24 months ago
24+ months ago
 
   
PRODUCT INTEREST

Please indicate the types of products you may be interested in purchasing or learning more about:
Product 1
Product 2
Product 3
Product 4
Product 5
Product 6
Product 7
Other
 
   
To help us serve you better, please tell us about your business:

Number of employees at your site:
1-100
101-250
251-500
501-1000
1000+
 
   
Annual budget for this product category:
$0-$10K
$10K-$50K
$50K-$100K
$100K+
Other (Please Specify)
 
   
Are you the person responsible for updates/purchases?
Yes
No
 
   
Is there another person in your organization who is responsible for purchasing [Product Class] or services?

Name
 
 
   
Title
 
 
   
Phone
 
 
   
Email
 
 
   
Thank you!
 
   
Permission to contact you via e-mail?
Yes
No
 


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