Earth Star Publishing
Client Feedback Survey

To help us serve you better, please complete
the following feedback survey.

We'd really appreciate your honest feedback.

When you submit your answers, you'll
be sent a copy of the book summary
of the best-selling book by Brian Tracy:

"Create Your Own Future"

Creating Your Own Future


Please complete the questions below.


First Name *
Last Name *
Email *
How would you rate your level of
overall satisfaction with Earth Star? *
1. Extremely satisfied
2.
3.
4.
5. Extremely Dissatisfied
Why do you say that? What specifically
are you satisfied or dissatisfied with
Earth Star? *
How likely are you to recommend
Earth Star to a friend or relative?
Would you say your chances are... *
Excellent
Very Good
Good
Fair
Poor
How likely are you to repurchase
products and services from Earth Star? *
Excellent
Very Good
Good
Fair
Poor
What were the top three reasons you
got products from Earth Star? *
What is your age?
Under 20 years
20 - 29 years
30 - 39 years
40 - 49 years
50 - 59 years
60 - 69 years
70 - 79 years
80 years
Birthday (DD/MM/YYYY)
What is your gender? *
Male
Female
What is your martial status? *
Single
Married
Separated
Divorced
What is your highest level of education? *
Year 10
Year 11
Year 12
TAFE
Undergraduate degree
Post-Graduate degree
What magazines do you read? *
What nutritional supplements do you take? *
What are your top three goals? *
What are your top three obstacles
in achieving those goals? *
What other products and/or services
would you like us to offer?