Please fill out the T&E Survey.

Once form is submitted a Return Label will be issued.
Name(Required)
Address(Required)
1 (Not Functional)2 (Somewhat Functional)3 (Functional)4 (Very Functional)5 (Extremely Functional)
1 (Very Hard to Use)2 (Hard to Use)3 (Average)4 (Easy)5 (Extremely Easy)
1 (Not Durable)2 (Somewhat Durable)3 (Durable)4 (Very Durable)5 (Extremely Durable)
1 (Not Worth the Cost)2 (Somewhat Worth the Cost)3 (Neutral)4 (Worth the Cost)5 (More than Worth the Cost)
1 (Very Unlikely)2 (Unlikely)3 (Neutral)4 (Likely)5 (Very Likely)
1 (Very Poor)2 (Poor)3 (Average)4 (Above Average)5 (Outstanding)
1 (Very Poor)2 (Poor)3 (Average)4 (Above Average)5 (Outstanding)
Are you planning on purchasing this product?(Required)