GENERAL INFORMATION

Full Name *
Company Name
Email Address *
Phone Number
Website

* Your full name and email address are required.

COMPANY DEMOGRAPHICS

How many employees does your company have?

0-99 100-249 250-499 500-999 1000+

What is the percentage of male vs. female employees?

Male % Female %

Please estimate the breakdown of your employee population by job category

Industrial % Clerical/Admin % Sales % Executive %

How many locations does the company have?

1-5 6-10 11-20 20+

How many locations are located outside of Canada?

PROGRAMS

Please indicate the types of programs currently in existence in your company:

Years of Service Sales Achievement Safety Performance Points Corporate Gifting Corporate Merchandise

What percentage of each type of product is incorporated into your existing program?

Traditional Items % Lifestyle Items %

How is your program administered?

Print brochures Web-based materials

Please rate each program area using the following scale: 1=Poor 2=Fair 3=Good 4=Very Good 5=Excellent

Years of Service
Products	1	2	3	4	5
Communication	1	2	3	4	5
Administration	1	2	3	4	5
Awards Presentation	1	2	3	4	5
Supplier Service	1	2	3	4	5

Sales Achievement
Products	1	2	3	4	5
Communication	1	2	3	4	5
Administration	1	2	3	4	5
Awards Presentation	1	2	3	4	5
Supplier Service	1	2	3	4	5

Safety
Products	1	2	3	4	5
Communication	1	2	3	4	5
Administration	1	2	3	4	5
Awards Presentation	1	2	3	4	5
Supplier Service	1	2	3	4	5

Performance
Products	1	2	3	4	5
Communication	1	2	3	4	5
Administration	1	2	3	4	5
Awards Presentation	1	2	3	4	5
Supplier Service	1	2	3	4	5

Points
Products	1	2	3	4	5
Communication	1	2	3	4	5
Administration	1	2	3	4	5
Awards Presentation	1	2	3	4	5
Supplier Service	1	2	3	4	5

Corporate Gifting
Products	1	2	3	4	5
Communication	1	2	3	4	5
Administration	1	2	3	4	5
Awards Presentation	1	2	3	4	5
Supplier Service	1	2	3	4	5

Corporate Merchandise
Products	1	2	3	4	5
Communication	1	2	3	4	5
Administration	1	2	3	4	5
Awards Presentation	1	2	3	4	5
Supplier Service	1	2	3	4	5

GENERAL COMMENTS