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Last Name:
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ZIP Code:
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Date of Installation:
Month
January
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September
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Day
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02
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Year
2008
2007
2006
2005
2004
2003
2002
2001
(if different from above)
Address 1:
Address 2:
(optional)
City:
State:
-- U.S. States
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
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Ohio
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Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP Code:
Best method to contact:
Phone
Email
Paper-mail
What is the overall cost of your remodeling project?
$0-$5,000
$5,001-$10,000
$10,001-$20,000
$20,001-$40,000
over $40,000
How did you hear about DuPont™ Simplicity®?
Phone
Email
Paper-mail
Word of Mouth
Retailer
Advertisement
Retailer
Builder
Fabricator/Installer
Website
Other
How satisfied are you with your countertop?
1 - Very dissatisfied 10 - Very satisfied
1
2
3
4
5
6
7
8
9
10
When you first started this project, what type or brand of countertop did you expect to purchase?
Laminate (such as Formica, Wilsonart or other)
DuPont Zodiaq® Quartz Surface
Other Quartz Surface (such as Avanza, Silestone or other)
DuPont Corian®
DuPont Simplicity®
Other Solid Surface (such as Gibraltar, Hi-Macs, Staron or other)
Granite
Other
Check all that apply
What was the salesperson's first recommendation for your project at the location where you bought your countertop?
Laminate (such as Formica, Wilsonart or other)
DuPont™ Zodiaq® Quartz Surface
Other Quartz Surface (such as Avanza, Silestone or other)
DuPont™ Corian®
DuPont™ Simplicity®
Granite Certified By DuPont™
Other Solid Surface (such as Gibraltar, Hi-Macs, Staron or other)
Other
Check all that apply