Chapter Visit Feedback Form

Chapter Visit Feedback Form

Our goal is that every member, visitor and substitute feel welcome and have an amazing experience at our chapter meeting. We would like your feedback on how we did today.
Today's Date:*

MonthDayYear
Date
Chapter You're Attending:*
Your Name:*

First NameLast Name
Company:*

1. How was our overall meeting?*

	1	2	3	4	5	6	7	8	9	10

1 is (Poor), 10 is (Excellent)

2. How welcome did we make you feel today?*

	1	2	3	4	5	6	7	8	9	10

1 is (Poor), 10 is (Excellent)

3. How could we have enhanced your experience? (Please, tell us what we don't want to hear.)*

4. Please list in order of preference (1-4) what you liked most about our meeting:*

	1	2	3	4
Business Generated - Helping you reach your financial goals faster.
Teamwork and Energy - Working together, supporting each other and having fun!
Relationships and Trust - The opportunity to develop long-lasting, meaningful friendships.
Structure and Learning - Staying on task while growing personally and professionally.

5. Do you see how your business could get referrals from this chapter?*

YesNo
6. Do you see how those referrals could turn into closed business?*

YesNo
7. Follow up is important to us. Based on your experience today, how would you like us to follow up with you? (Please check one)*

I Am Ready to Apply - I would like to apply for membership now, please!I Am Ready to Apply - I just need to work out the financesI Am Ready to Apply - I just need to discuss with my business partner/bossI Am Very Interested - I just need to find a chapter with a different day/time/locationSorry, Not Now - The timing is not right at this time.
8. What is the best way to follow up with you?*

PhoneTextEmailOther
Phone:*

Area CodePhone Number
Email:*
example@example.com
Other:*
9. Which chapter members can we connect you with in a meaningful way? (Optional)
Thank you for visiting the chapter today. We look forward to connecting with you and helping you reach your goals.
Should be Empty: