Items in RED are required fields.

BC Group Reference # or Invoice Number
Date Received	Day:  Month:  Year:
Your Salesperson
	<---Not Satisfied    Totally Satisfied--->
Communication - Before, during, & after the sale	1   2   3   4  5
Delivery - Timeliness	1   2   3   4  5
Quality - Total quality in all aspects of this transaction	1   2   3   4  5
Responsiveness - Courtesy & professionalism	1   2   3   4  5
Comments
Based on this service transaction, are you likely to buy from BC Group the next time you have a need?	Yes         No
Would you like to be personally contacted to discuss our performance?	Yes         No
If you wish to be contacted, please fill in below:
Your name
Organization
Country
E-mail
Telephone
FAX

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