reports.boostrewards.com Open in urlscan Pro
74.218.154.174  Public Scan

Submitted URL: http://apps.shumsky.com/skyweb/survey/survey.cfm?OrderNo=A996729&MasterAcct=50797
Effective URL: https://reports.boostrewards.com/skyweb/survey/survey.cfm?OrderNo=A996729&MasterAcct=50797
Submission: On March 10 via manual from US — Scanned from DE

Form analysis 1 forms found in the DOM

Name: SurveyPOST survey_insert.cfm

<form name="Survey" id="Survey" action="survey_insert.cfm" method="post" onsubmit="return _CF_checkSurvey(this)">
  <input type="hidden" name="OrderNo" value="A996729">
  <input type="hidden" name="MasterAcct" value="50797">
  <table width="760" border="0" cellspacing="0" cellpadding="0" align="center">
    <tbody>
      <tr align="left">
        <td colspan="2"><br>
          <hr>
        </td>
      </tr>
      <tr bgcolor="#CCCCCC">
        <td>
          <div class="indent"><strong>Customer Information:</strong></div>
        </td>
        <td>&nbsp;</td>
      </tr>
      <tr>
        <td width="269" height="27" align="right">Company Name:</td>
        <td width="491"><input type="text" name="company"></td>
      </tr>
      <tr>
        <td align="right">Name (Optional):</td>
        <td><input type="text" name="customer"></td>
      </tr>
      <tr>
        <td align="right">Daytime Phone (Optional):</td>
        <td><input type="text" name="phone"></td>
      </tr>
    </tbody>
  </table>
  <table width="760" border="0" cellspacing="0" cellpadding="0" align="center">
    <tbody>
      <tr bgcolor="#CCCCCC">
        <td colspan="2" align="right">
          <div class="indent">
            <div align="left">During the online order process did you interact with a customer service representative? If so did you find them:</div>
          </div>
        </td>
      </tr>
      <tr>
        <td width="307">Courteous?</td>
        <td width="453">
          <table border="0" class="optionsTable">
            <tbody>
              <tr>
                <td><input name="courteous" type="radio" value="excellent"><label for="courteous">Excellent</label></td>
                <td><input name="courteous" type="radio" value="good"><label for="courteous">Good</label></td>
                <td><input name="courteous" type="radio" value="fair"><label for="courteous">Fair</label></td>
                <td><input name="courteous" type="radio" value="poor"><label for="courteous">Poor</label></td>
              </tr>
            </tbody>
          </table>
        </td>
      </tr>
      <tr>
        <td>Helpful?</td>
        <td>
          <table border="0" class="optionsTable">
            <tbody>
              <tr>
                <td><input name="helpful" type="radio" value="excellent"><label for="helpful">Excellent</label></td>
                <td><input name="helpful" type="radio" value="good"><label for="helpful">Good</label></td>
                <td><input name="helpful" type="radio" value="fair"><label for="helpful">Fair</label></td>
                <td><input name="helpful" type="radio" value="poor"><label for="helpful">Poor</label></td>
              </tr>
            </tbody>
          </table>
        </td>
      </tr>
      <tr>
        <td>Quick and efficient?</td>
        <td>
          <table border="0" class="optionsTable">
            <tbody>
              <tr>
                <td><input name="quick" type="radio" value="excellent"><label for="quick">Excellent</label></td>
                <td><input name="quick" type="radio" value="good"><label for="quick">Good</label></td>
                <td><input name="quick" type="radio" value="fair"><label for="quick">Fair</label></td>
                <td><input name="quick" type="radio" value="poor"><label for="quick">Poor</label></td>
              </tr>
            </tbody>
          </table>
        </td>
      </tr>
      <tr>
        <td>Knowledgeable about your program?</td>
        <td>
          <table border="0" class="optionsTable">
            <tbody>
              <tr>
                <td><input name="knowledgeable" type="radio" value="excellent"><label for="knowledgeable">Excellent</label></td>
                <td><input name="knowledgeable" type="radio" value="good"><label for="knowledgeable">Good</label></td>
                <td><input name="knowledgeable" type="radio" value="fair"><label for="knowledgeable">Fair</label></td>
                <td><input name="knowledgeable" type="radio" value="poor"><label for="knowledgeable">Poor</label></td>
              </tr>
            </tbody>
          </table>
        </td>
      </tr>
      <tr>
        <td align="right">
          <div align="left"></div>
        </td>
        <td>&nbsp;</td>
      </tr>
      <tr bgcolor="#CCCCCC">
        <td colspan="2">
          <div align="left" class="indent">
            <div align="left">Did you receive your merchandise:<font color="#FF0000" size="2" face="Arial, Helvetica, sans-serif"><b> (If applicable) </b></font>
            </div>
          </div>
        </td>
      </tr>
      <tr>
        <td>In good condition?</td>
        <td>
          <table border="0" class="optionsTable">
            <tbody>
              <tr>
                <td><input name="condition" type="radio" value="excellent"><label for="condition">Excellent</label></td>
                <td><input name="condition" type="radio" value="good"><label for="condition">Good</label></td>
                <td><input name="condition" type="radio" value="fair"><label for="condition">Fair</label></td>
                <td><input name="condition" type="radio" value="poor"><label for="condition">Poor</label></td>
              </tr>
            </tbody>
          </table>
        </td>
      </tr>
      <tr>
        <td align="right">
          <div align="left">Exactly as you expected?</div>
        </td>
        <td>
          <table border="0" class="optionsTable">
            <tbody>
              <tr>
                <td><input name="expected" type="radio" value="excellent"><label for="expected">Excellent</label></td>
                <td><input name="expected" type="radio" value="good"><label for="expected">Good</label></td>
                <td><input name="expected" type="radio" value="fair"><label for="expected">Fair</label></td>
                <td><input name="expected" type="radio" value="poor"><label for="expected">Poor</label></td>
              </tr>
            </tbody>
          </table>
        </td>
      </tr>
      <tr>
        <td align="right">
          <div align="left">On time?</div>
        </td>
        <td>
          <table border="0" class="optionsTable">
            <tbody>
              <tr>
                <td><input name="timing" type="radio" value="excellent"><label for="timing">Excellent</label></td>
                <td><input name="timing" type="radio" value="good"><label for="timing">Good</label></td>
                <td><input name="timing" type="radio" value="fair"><label for="timing">Fair</label></td>
                <td><input name="timing" type="radio" value="poor"><label for="timing">Poor</label></td>
              </tr>
            </tbody>
          </table>
        </td>
      </tr>
      <tr>
        <td align="right">
          <div align="left"></div>
        </td>
        <td>&nbsp;</td>
      </tr>
      <tr bgcolor="#CCCCCC">
        <td colspan="2">
          <div class="indent">
            <div align="left">Was the shopping website: </div>
          </div>
        </td>
      </tr>
      <tr>
        <td align="right">
          <div align="left">Easy to navigate?</div>
        </td>
        <td>
          <table border="0" class="optionsTable">
            <tbody>
              <tr>
                <td><input name="navigate" type="radio" value="excellent"><label for="navigate">Excellent</label></td>
                <td><input name="navigate" type="radio" value="good"><label for="navigate">Good</label></td>
                <td><input name="navigate" type="radio" value="fair"><label for="navigate">Fair</label></td>
                <td><input name="navigate" type="radio" value="poor"><label for="navigate">Poor</label></td>
              </tr>
            </tbody>
          </table>
        </td>
      </tr>
      <tr>
        <td align="right">
          <div align="left">Organized and readable?</div>
        </td>
        <td>
          <table border="0" class="optionsTable">
            <tbody>
              <tr>
                <td><input name="organized" type="radio" value="excellent"><label for="organized">Excellent</label></td>
                <td><input name="organized" type="radio" value="good"><label for="organized">Good</label></td>
                <td><input name="organized" type="radio" value="fair"><label for="organized">Fair</label></td>
                <td><input name="organized" type="radio" value="poor"><label for="organized">Poor</label></td>
              </tr>
            </tbody>
          </table>
        </td>
      </tr>
      <tr>
        <td align="right">
          <div align="left">Filled with a balanced selection of products?</div>
        </td>
        <td>
          <table border="0" class="optionsTable">
            <tbody>
              <tr>
                <td><input name="selection" type="radio" value="excellent"><label for="selection">Excellent</label></td>
                <td><input name="selection" type="radio" value="good"><label for="selection">Good</label></td>
                <td><input name="selection" type="radio" value="fair"><label for="selection">Fair</label></td>
                <td><input name="selection" type="radio" value="poor"><label for="selection">Poor</label></td>
              </tr>
            </tbody>
          </table>
        </td>
      </tr>
      <tr>
        <td align="right">
          <div align="left">Are there any specific products that you would like to have added to the selection? </div>
          <br>
          <br>
          <br>
          <br>
        </td>
        <td>
          <textarea name="products" cols="40" rows="4" id="products"></textarea>
        </td>
      </tr>
      <tr bgcolor="#CCCCCC">
        <td colspan="2">
          <div class="indent">General Comments:</div>
        </td>
      </tr>
      <tr>
        <td colspan="2">
          <div class="comments">
            <p>
              <textarea name="comments" cols="60" rows="4" id="comments"></textarea>
            </p>
          </div>
        </td>
      </tr>
      <tr>
        <td colspan="2" align="right">
          <div align="center">
            <input type="submit" name="Submit" value="Submit">
          </div>
        </td>
      </tr>
    </tbody>
  </table>
</form>

Text Content



--------------------------------------------------------------------------------

Customer Information:
  Company Name: Name (Optional): Daytime Phone (Optional):

During the online order process did you interact with a customer service
representative? If so did you find them:
Courteous?

Excellent Good Fair Poor

Helpful?

Excellent Good Fair Poor

Quick and efficient?

Excellent Good Fair Poor

Knowledgeable about your program?

Excellent Good Fair Poor


 
Did you receive your merchandise: (If applicable)
In good condition?

Excellent Good Fair Poor

Exactly as you expected?

Excellent Good Fair Poor

On time?

Excellent Good Fair Poor


 
Was the shopping website:
Easy to navigate?

Excellent Good Fair Poor

Organized and readable?

Excellent Good Fair Poor

Filled with a balanced selection of products?

Excellent Good Fair Poor

Are there any specific products that you would like to have added to the
selection?




General Comments:






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