Customer Questionnaire

Company or Organization name A value is required.Invalid format.

Name of contact person A value is required. A value is required.

Address A value is required. A value is required.

City, State, Zip code A value is required. A value is required.

Phone number

E-mail address A value is required.Invalid format. A value is required.Invalid format.

Website address

What does the company/organization do?

What is the goal of the company/organization?

What demographic or target audience are you trying to reach?

Are you targeting a specific geographic region? Yes No

If yes, which regions are you targeting (city, state, country)?

What are your hours of operation? A value is required.

Do you have a physical office or store? Yes No

What benefits do consumers receive from your products? What services do you offer that benefit/improve their lives? (list several benefits, services in a list)

What is your company/organization's tagline?

What types of products are you interested in (please check all that apply)?

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