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10
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1
Name
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First Name
Last Name
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2
Email
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example@example.com
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3
Phone Number
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Please enter a valid phone number.
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4
When’s is the last time you were a consumer in East Texas?
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Daily
Weekly
Monthly
In last 6 months
Over 6 months
Never
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5
Which Restaurant are you most familiar with?
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Sky Bar Grill
Twelve
The Grove Kitchens & Gardens
Prime 102
None
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6
Which Car Dealership are you most familiar with?
*
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Gabriel/Jordan Buick GMC
Hall Buick GMC
Wagner Cadillac
Peltier Chervolet
None
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7
Which Pharmacy are you most familiar with?
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Rose City Pharmacy
Kinsey’s Pharmacy
Brickstreet Pharmacy
Majors Pharmacy
None
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8
Which Roofing Company are you most familiar with?
*
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A to Z Roofing
JNR Commercial Roofing
Clean Cut Roofing
Hargrove Roofing
None
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9
Which Grocery Store are you most familiar with?
*
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Brookshires/Super 1/Fresh
Walmart
HEB
None
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10
How likely are you to recommend one of the above brands to someone you know?
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1
2
3
4
5
Not Likely
Very Likely
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