1. PRODUCT INFORMATION

Model:	*	Serial Number:	*
Date of Purchase:	*

2. CUSTOMER INFORMATION  

Company:	*
Address:	*
Telephone:	*	Fax:
E-mail:	*

3. NAME OF ESCO DISTRIBUTOR

   Contact:	*
   Company:	*	Country:	*

4. Have you been using other brands before Esco? Yes     No

If yes, please kindly tell us the brands that you have been using:


5. Do you have any complaints or suggestions for Esco product? Yes     No

   If yes, please state your comments:
   

6. Please rate your opinion on the following subjects accordingly.
   If you think Esco has done a good job on the subject, you may give it a score of 5. If you think Esco still has a long way to go to achieve customer expectation on the subject, you may give it a score of 1. You can also give a score between 1 and 5 to show your opinion.

	Poor ---------------------------------- Good
Price	1     2     3     4     5
On-time delivery	1     2     3     4     5
Service response	1     2     3     4     5
Physical appearance / design	1     2     3     4     5
Build quality	1     2     3     4     5
Product reliability	1     2     3     4     5
Product documentation	1     2     3     4     5
Product packaging	1     2     3     4     5
Ergonomics	1     2     3     4     5
Ease of use	1     2     3     4     5
Brand recognition	1     2     3     4     5

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