Kitimat CDC Satisfaction Survey Form

1

Name* This field is required.

First Name

Last Name

2

Company Name* This field is required.

3

Phone Number* This field is required.

Please enter a valid phone number.

4

Email* This field is required.

example@example.com

5

Are you also golfing?* This field is required.

YESNO

6

Which sponsorship(s) would you like to choose?Remember the level

8

Amount in CAD* This field is required.

9

Payment Method* This field is required.

Cheque (Mail or In-Person at 1515 Kingfisher Ave, Kitimat, BC)

Credit or Debit (In-Person at 1515 Kingfisher Ave, Kitimat, BC)

Pre-Authorized Credit Card Transaction (We'll email you a form1)