To receive your 25% off next purchase coupon,

simply fill out this short survey about the quality of our website

and we will send you your coupon via fax or email.

Name:     Date:

Company:     Address:

City:     State:     Zip Code:     Phone:    Fax:


For each item below, using the drop-down box, select the number that best fits your opinion of its quality.

1 being Poor and 5 being Excellent

1. Appearance of our website
2. Ease of use (easy to navigate)
3. Color Scheme
4. Information provided
5. Overall satisfaction

Any addition suggestions or comments would be greatly appreciated: